title: Self-assessment in neurological surgery: the SANS wired white paper.
abstract: OBJECTIVE
  Periodic self-assessment is an important component of postgraduate medical education and certification. The Self-assessment in Neurological Surgery (SANS) examination has a history of usefulness for neurosurgical written and oral board examination preparation. The SANS Wired test represents a recreation of the original SANS test using an Internet-based platform. Advanced functionality and contemporary content have been added to meet the increasing requirements for demonstration of lifelong learning and self-assessment as part of the Maintenance of Certification (MOC) process.
  
  
  METHODS
  A needs assessment was performed before the development of SANS Wired. Postexamination surveys for users obtaining continuing medical education credit were analyzed for user satisfaction with the platform and content. Test-item performance metrics were analyzed based on first-attempt responses. The economic value of SANS Wired as a component of the mandatory MOC process was evaluated.
  
  
  RESULTS
  The needs assessment identified a deficiency of available content and mechanisms for neurosurgery-specific self-assessment. As of October 15, 2005, a total of 588 individuals had subscribed to SANS Wired (28 institutional licenses accounted for 229 users). Eighty-eight post-test surveys were analyzed for user satisfaction. Ninety-four percent of responses indicated that learning objectives had been met. Initial performance metrics show an average point-biserial discrimination index of +0.18 for all test items.
  
  
  CONCLUSIONS
  The SANS Wired system seems to be an effective platform for neurosurgical self-assessment and is acceptable to users. The system satisfies, in part, two of the four required components of MOC, namely, periodic self-assessment and demonstration of cognitive expertise. It is endorsed by the American Board of Neurological Surgeons for MOC.
authors.affiliation: Department of Neurosurgery, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Ragel
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Asher
authors.forename: Nathan
authors.initials: N
authors.lastname: Selden
authors.forename: Joel D
authors.initials: JD
authors.lastname: MacDonald
mesh_terms: D002568:Certification; D003258:Consumer Behavior; D004503:Education, Medical, Graduate; D004521:Educational Measurement / Q000379:methods* / Q000592:standards*; D006801:Humans; D020407:Internet; D009493:Neurosurgery / Q000193:education*; D012647:Self-Assessment