Anesthesia Knowledge Test Series Examinations Instructions Revised as of: 07/31/2014 Metrics Associates, Inc John A. Jensen
1 Introduction The Anesthesia Knowledge Test series of examinations are standardized tests designed to provide formative assessment of anesthesiology residents at 1, 6, and 24 months of clinical anesthesia training. In order for the tests to perform as intended, it is imperative that they are administered under the conditions detailed in these instructions. 2 The Institutional Examiner and Proctor(s) The AKT examinations and their associated materials are distributed only to ACGME accredited anesthesiology residency training programs. The residency program director is designated as the Institutional Examiner and is responsible for ensuring that the terms and conditions for the examinations and the specified procedures for administration of the examinations are followed. NOTE: It is imperative that the security of the examination materials be maintained at all times. It is also essential that the instructions for administration of the examinations are followed completely. The Institutional Examiner may delegate to others the responsibility for supervising the administration of the examinations (referred to hereafter as proctors). However, the Institutional Examiner is responsible for ensuring that all proctors understand and follow the rules for administering the examinations and for maintaining appropriate security of the examinations. NOTE: Both examination security and appropriateness of administration are ultimately the responsibility of the Institutional Examiner, even if some of the tasks are delegated to others. 3 Terms and Conditions for the Anesthesia Knowledge Test Series of Examinations The following terms and conditions apply to all examinations in the Anesthesia Knowledge Test series (AKT 1 pre and post test; AKT 6; and AKT 24). All examination materials, including all questions, are the sole property of the Inter hospital Study Group for Anesthesia Education. Any copying, reproducing, memorizing and later reproducing, or disseminating questions is strictly prohibited. Any violation of these conditions violates the terms and conditions of the examinations. The Interhospital Study Group for Anesthesia Education reserves the right to pursue any and all legal remedies available in the event of violation of these terms and conditions. Examinees will be asked to read the terms and conditions prior to beginning any AKT examination and to sign a statement that acknowledges that they have read, understood, and will abide by the terms and conditions of the examination. Any resident who declines to do so may not take the examinations. Violation of the terms and conditions by the Institutional Examiner or Proctors may lead to the exclusion of the involved residency program from participation in the AKT examinations. 1
4 Testing Materials AKT Special Instructions When a testing packet arrives at a participating institution, the Institutional Examiner or designee should check the packet to be certain that the ordered materials have been shipped. These materials should include: 1. an Administrator's Manual, if ordered; 2. the number of test booklets ordered; 3. a specimen answer sheet; 4. the number of answer sheets that were ordered (same as the number of test booklets); 5. a sufficient quantity of No. 2 soft pencils; 6. Anesthesia Knowledge Test Series Terms and Conditions to be filled out and sent back with exams being returned for scoring; 7. authorization to receive AKT Results by e mail form (if you wish to receive results this way and have not yet returned this form); 8. an itemized invoice if payment is due; and, 9. a self addressed return envelope. Should any needed materials be missing, contact Metrics Associates immediately at (978) 256 9344. NOTE: To maintain the security of the AKT examinations, the examinations should be kept in a secured and locked location before and after administration. 5 Examination Administration Below are the instructions for the Institutional Examiner and/or Proctor(s) to follow when administering any of the examinations in the AKT series. In the instructions, the person supervising the administration of the examinations is referred to as the Proctor. 5.1 General Information 1. The Proctor should be thoroughly familiar with the testing materials and the specified procedures before the administration of any examinations. A sample completed answer sheet has been included in the shipped materials to show how the information grids on each answer sheet should be completed. 2. Examinees should be given reasonable advance notice of when an examination will be administered. Under no circumstances should an examinee be required to respond to an AKT examination without having been properly informed concerning its administration, or without the requisite time in which to consider and respond to the test questions in an atmosphere relatively free from anxiety. 2
3. The AKT 1 is available in two forms (A and B) intended to be administered as a pre test and a post test at the beginning and end of the first month of clinical anesthesia training (CA 1 year). Form A and Form B may be regarded as equivalent in terms of what they measure. One of the two forms has been designated as the pre test for your institution and the other, the post test. This has been done to ensure balance across the national sample. Test booklets are appropriately stamped on their front covers to indicate their proper use. 5.2 Optically Scanned Answer Sheets Examinees will record their responses on answer sheets that will be scored using optical scanning. To ensure accurate scoring, examinees must us a No. 2 soft lead pencil to mark the answer sheets. All circles must be completely filled to ensure that the information is appropriately recognized by the scanning equipment. Please observe the following guidelines: 5.2.1 MARKING The optical scanner will only recognize marks that have been made using a soft lead pencil (No. 2 pencil). Any lighter pencil or any ball point pen marks entered will not be recognized dependably by the scanner. Thus, use of a proper pencil in completing the response sheet cannot be overemphasized. Also, the small circles used to record each response must be completely filled, not simply marked with an X or checkmark. Instructions for proper marking of the response sheet are found on the reverse side of the response sheet. 5.2.2 ERASING ENTRIES Responses may be changed; however, the prior response must be completely erased in order for the response change to be complete. 5.2.3 CONDITION OF TESTING MATERIALS Examinees may make any marks they wish on the examination booklet. It may also be folded as examinees desire. The response sheet, however, must not be folded, stapled, or ripped as doing so will hamper its passage through the scanning equipment. 5.2.4 IDENTIFYING INFORMATION Special attention should be given to the response blocks that serve to uniquely identify each examinee and the examinee's institution, time of testing, and form used. Entering the resident s employee identification number will help ensure that residents with the same first and last name can be distinguished. Additional detailed information is included in the specific instructions for each examination. 3
5.3 Materials Needed AKT Special Instructions In preparing to administer the AKT, the Proctor for the examination session should ensure that the following materials are available: 1. A copy of the AKT examination book for each examinee (appropriately labeled for the time the examination is to be given i.e., either pre or post if administering the AKT 1); 2. The appropriate answer sheet for the examination to be given. At least one No. 2 soft lead pencil for each examinee (Note: colored pencils, hard lead pencils and pens of any color will not be recorded by the optical scanner); 3. The instructions for administering the examination; 4. A watch or clock to be used in timing the examination session5. A sign which reads, "Examination in Progress Do Not Disturb," for any door leading to the examination area. 5. A proctor must remain with the examinees throughout the administration of the examination. 5.4 Instructions for Administration of the AKT Examinations 5.4.1 General Instructions 1. An appropriate examination session requires that these instructions are followed in their entirety. 2. The room in which the examination is administered should be free from distractions, provide ample room for each examinee to comfortably complete the examination, be well lighted, and properly ventilated. 3. The examination room should be available for two and one half hours for the AKT 1 and 6 examinations and three hours for the AKT 24 examination. This will allow adequate time for the proctor to review the instructions with the examinees and for the examinees to take the examination. An examination should not be scheduled when insufficient time is available for completion. 4. Time limits given for the AKT examinations must be strictly enforced. In order for the normative data provided to residents and programs to have maximum value, the examinations must be given under the standard conditions described in these instructions, including strict adherence to the time limit for each examination. 5. Examinees may leave the room when they have completed the examination. If all examinees complete the examination before the time limit has expired, the session may be ended. 4
5.4.2 Specific Instructions The testing are must be free of any materials that might aid examinees in responding to questions on the examination. 1. Place a sign indicating that testing is in progress on each door that leads to the designated examination area ("Examination in Progress Do Not Disturb"). 2. Check attendance, and be sure to verify the identification of all examinees sitting for the examination session. 3. Instruct examinees to turn off mobile phones and pagers for the duration of the examination. 4. If administering the AKT 1, make certain that those taking the pre test or post test receive appropriate booklets (each is marked for pre or post administration on the cover). 5. Tell examinees not to open their test booklets until told by you to do so. 6. Distribute one examination booklet, one response sheet and at least one sharpened No. 2 pencil to each examinee. 7. Have each examinee complete the information blocks on the answer sheet as follows by reading the instructions below to the examinees. Once all materials are distributed and examinees are seated, the Proctor should say to the examinees: "All marks on the response sheet must be made using a No. 2 soft pencil. All circles that are marked should be completely filled. If any corrections are made, erase the incorrect response completely. Turn the response sheet so that the information blocks are to the left. Print your last name, first name, and middle initial, if any, in the blocks provided. Do not use more space than is provided for each part of your name. Beneath each letter of your name mark the corresponding letter on the grid by completely filling the circle Pause until all have finished, then say: "In the grid labeled 'Today's Date' fill in the circle that corresponds to the current month. In the blocks labeled 'Day' and 'Yr.', enter as digits the day of the current month and the last two digits of the current year. In each column, fill in the number that corresponds to the number printed above." Pause until all have finished, then say: "In the blocks over the middle grid labeled 'Employee ID Number', enter your Employee Identification Number. If you do not have an Employee Identification Number, leave this grid blank. Beneath each number entered in the Employee ID Number blocks, blacken the corresponding number on the grid." 5
Pause until all have finished, then say: "In the next three blocks, labeled 'Institution Number', enter the number for your institution. It is the first three digits of the control number that appears on the cover of your test booklet. Beneath the numbers you entered in the institution number blocks, blacken the corresponding numbers on the grid." Use the tables below to determine the appropriate response for the examinees to enter under TYPE on the response sheet. [CBY= Clinical Base Resident; CA 1, 2, or 3 = Clinical Anesthesia Resident 1, 2, or 3] AKT 1 Pre test TYPE CRITERIA 1 1. A CBY resident with a minimum of 11 months of completed CBY training taking the exam for the first time within 7 days of beginning clinical anesthesia training. 2. A CA 1 resident taking the exam for the first time within 7 days of beginning clinical anesthesia training. 4 Any resident who does not meet the criteria for Type 1 above. AKT 1 Post test TYPE CRITERIA 1 1. A CBY resident with a minimum of 11 months of completed CBY training taking the exam for the first time after 4 6 weeks of clinical anesthesia training. 2. A CA 1 resident taking the exam for the first time after 4 6 weeks of clinical anesthesia training. AKT 6 TYPE 2 4 Any resident who does not meet the criteria for Type 1 above. CRITERIA 1. A CA 1 resident taking the examination for the first time who has completed 6 7 months of clinical anesthesia training. For example, a resident who began the CA 1 year in July and is taking the examination in December or January. 5 Any resident who does not meet the criteria for Type 2 above. 6
AKT 24 TYPE CRITERIA 3 1. A resident taking the examination for the first time who has completed 23 25 months of clinical anesthesia training. For example, a resident who began clinical anesthesia residency training in July taking the examination in June of the CA 2 year or July of the CA 3 year. 6 Any resident who does not meet the criteria for Type 3 above. The proctor should say: Enter [Type determined from tables above] in the box labeled TYPE and blacken the corresponding number on the grid below the box. If administering the AKT 1 Pre test say: "Just to the right of the name grid are two grids labeled 'TIME' and 'FORM'. In the block labeled 'TIME', blacken the circle labeled 'PRE'. Check the front cover of your booklet to confirm that it is labeled Pre test." "In the block labeled 'FORM', blacken the circle labeled 'A' if you are responding to Form A of the AKT 1, or blacken the circle labeled 'B' if you are responding to Form B. Check the front cover of your booklet to confirm that you have entered the proper form code." If administering the AKT 1 Post test say: "Just to the right of the name grid are two grids labeled 'TIME' and 'FORM'. In the block labeled 'TIME', blacken the circle labeled 'POST' Check the front cover of your booklet to confirm that it corresponds with your testing time." "In the block labeled 'FORM', blacken the circle labeled 'A' if you are responding to Form A of the AKT 1, or blacken the circle labeled 'B' if you are responding to Form B. Check the front cover of your booklet to confirm that you have entered the proper form code." Pause until all have finished, then say: "Notice that the response block for each item consists of 5 lettered circles, labeled 'A' through 'E', and that the item response areas are arranged in columns, each of which contains response areas for ten items. Responses to the first 80 items are to be recorded on the front of the response sheet. Responses to the remaining items should be made on the reverse side of the response sheet. Please be ensure that you record the response to each question next to the number that corresponds to the question number in the examination booklet." "When entering your response to each question, be sure to blacken the entire circle that is appropriate for your intended response. Do not check or 'X' out the circle. Examples of right and wrong ways to respond to an item are given toward the right side of the back of the answer sheet." 7
"Are there any questions concerning how you should record your responses to the test questions?" Answer any questions that arise. Now, open the cover of your test booklet and read the Examinee and Proctor Information Section on the left hand page. The following terms and conditions apply to all examinations in the Anesthesia Knowledge Test series (AKT 1 pre and post test; AKT 6; and AKT 24). All examination materials, including all questions, are the sole property of the Inter hospital Study Group for Anesthesia Education. Any copying, reproducing, memorizing and later reproducing, or disseminating questions is strictly prohibited. Any violation of these conditions violates the terms and conditions of this examination. The Inter hospital Study Group for Anesthesia Education reserves the right to pursue any and all legal remedies available in the event of violation of these terms and conditions. Once you have read the terms and conditions, complete the acknowledgement section by printing your name and employee identification number and signing your name in the spaces provided. If you are unwilling to abide by the terms and conditions of the examination, you may not take the examination and you must inform the proctor now. "Now, read the section labeled, 'General Directions', found on the right hand page. It is to your advantage to respond to all questions. There is no penalty for guessing." Pause until all have finished. Then say: Are there any questions? Answer any questions that the examinees ask concerning the administration of the examination. For the ATK 1 Pre and Post Test and AKT 6 say: You will have 2 hours to complete the examination. You may begin now. For the AKT 24 say: You will have 2 ½ hours to complete the examination. You may begin now. 8
5.4.3 After Administering the AKT 1. When two hours of examination time have elapsed (two and one half hours if administering the AKT 24), tell the examinees to stop. Gather the test materials from the examinees and dismiss them. 2. Complete the block on the inside front cover labeled, "To Be Completed By Proctor" for each examination booklet. Note any irregularities and sign your name where indicated. 3. Check each response sheet to be certain that examinees have properly completed the identification blocks, have erased completely any entries which were to have been changed, and have made no stray marks anywhere. Correct any recording errors noted. 4. Return the test booklets and completed response sheets in the envelope provided to: METRICS ASSOCIATES, INC. 6 North Road Chelmsford, MA 01824 9