In 1963, when the AAOS introduced its examination program, Bob Dylan was singing, “The times, they are a-changin’.” And, although the examinations program has been changing over the past 50 years, the change going into effect this year is as radical as Dylan’s prediction that “The order is rapidly fadin’.”

As of January 2014, the AAOS eliminated the print format as an option for completing a self-assessment examination (SAE). Going forward, all AAOS examination programs will only be available in an online format.

Making the shift
The Orthopaedic In-Training Exam (OITE) and the Orthopaedic Self-Assessment Examination (OSAE) were introduced before computers became a part of daily life. During the ensuing years, the AAOS examinations program grew to include 10 special interest exams—also in print. It wasn’t until 1991 that an electronic examinations format was offered on disc. By the end of that decade, the Internet enabled learners to complete examinations online wherever an Internet connection was available.

Although many members initially preferred the print format, the popularity of the online format has been increasing. Residents and orthopaedic surgeons in practice complete the OITE using an online program. The American Board of Orthopaedic Surgery (ABOS) conducts the Part 1 and Maintenance of Certification (MOC) examinations using a computerized format offered at a testing center. More and more, examinations are completed online or include an online component.

Since the implementation of the scored-and-recorded requirement for MOC, AAOS members who used the print format still had to enter their answers online at the Scoring Center before they received their scores and comparison with others taking the examination. Once members enter their answers and complete an evaluation survey, their CME credits are posted to their Transcript File automatically.

Online format details
As the AAOS releases new 2014 special interest examinations and the Orthopaedic Knowledge Update (OKU) SAE, it will make the shift to an online format for all new and existing examinations. Purchasing an examination gives the member lifelong access to the educational program.

Members can complete the examination, get their scores and CME credits, erase the answers, and complete the examination again. Answers can be reviewed at anytime, anywhere there is Internet access. Members will still be able to print the examination from the online file—one question at a time! After completing an examination, members can even purchase a print answer book to keep on hand at home or in the office.

The online self-assessment format has several advantages. Video material can supplement the discussion of a test question and enrich the learning experience. More images can be used to enhance testing and learning. For example, if the question uses a magnetic resonance image or computed tomography scan, the online learner can view multiple images in different planes to interpret findings. In addition, learners can watch a surgical procedure demonstration while reviewing test items, just as they watch videos online. These enhancements are built in, and are at no additional expense to the learner.

New programs coming
Recently, the AAOS Board of Directors approved three new examinations for members. The programs will roll out over the next 2 years.

The first is a focused examination on the hand, wrist, and forearm designed for the orthopaedic surgeon who has an interest in managing patients with problems in this anatomic area. Test items will focus on orthopaedic principles; mechanics; injuries to the bones, joints, and tendons; reconstruction; degenerative disease; and sports-related problems. As with other special interest examinations, this program will provide up to 10 CME credits upon completion.

The second new exam will be designed to accompany the Comprehensive Orthopaedic Review (COR) textbook, a popular resource for both residents and practicing orthopaedic surgeons. This original examination will test knowledge across all orthopaedic content domains. The combined COR textbook and examination program will provide valuable CME credits, similar to the OKU home study program.

The final new program is unlike anything the AAOS has ever offered before. The AAOS Test Preparation Center (TPC) will be an online learning community of orthopaedic surgeons and residents. It will include a databank of thousands of questions that create the opportunity for the learner to build a personalized examination.

The TPC concept also affords learners the opportunity to be teachers. For each examination question, participants can post commentary based on opinion, orthopaedic literature, or patient case experience. Residency program directors participating in the ResStudy online examination program will be able to create rotation-specific pre- and posttests. Complimentary access to the TPC will be included in the registration fee for the AAOS Board Preparation and Review Course.

The Academy’s examination program is improving and growing to ensure that AAOS members have the educational assessment programs necessary for evaluating knowledge, charting a course of study, and preparing for high-stakes testing.

Howard Mevis is director of the AAOS department of electronic media, electronic programs, CME, course operations, and practice management group. He can be reached at mevis@aaos.org