From the Board of Trustees

From the Board of Trustees

Item Writer Training Ensures High-Quality, Consistent Exams

By Kyle Dignoti, ABR Editor; M. Elizabeth Oates, MD, ABR Trustee; and David B. Larson, MD, ABR Trustee


By Kyle Dignoti, ABR Editor; M. Elizabeth Oates, MD, ABR Trustee; and David B. Larson, MD, ABR Trustee

The ABR is committed to producing high-quality, fair exams, and a network of volunteer writers is responsible for authoring meaningful exam questions. For new writers, the introduction to content creation begins with an orientation by the editing division, with guidance from the recently established volunteer-led Language and Style Committee (LSC).

All new content writers are invited to participate in an orientation led by editing staff. In this short but comprehensive training, writers are introduced to the ABR’s standards for well-written items. With so many experts writing content across various disciplines, the language and style guidelines keep content consistent and ensure that items are written in a similar voice.

The orientation covers topics such as chronological presentation of information, common psychometric issues to avoid, and preferred syntax for voice and tone. The training equips writers with the best practices for writing items, providing examples of high-quality items and strategies for avoiding common pitfalls. Writers learn how to create plausible, well-balanced options, effectively incorporate numbers and abbreviations, and construct items that test a single concept. To maintain the credibility of exams, writers are required to provide well-researched references that support every answer.

The item writer orientation ensures that all ABR volunteers are working within the same framework. The orientation demystifies the writing process and gives item writers the tools they need to maintain exam quality and integrity. Clarity and conciseness are emphasized, and writers are provided with strategies for eliminating redundancies and any wording structures that could confuse an examinee. These conventions are overseen and updated by a committee of volunteers.

The LSC is made up of subject matter experts who ensure that ABR exams use the most current and accurate terminology and language. Because abbreviations are so prevalent in medicine, one of the committee’s most important tasks is determining which are appropriate to use across all exams. While the ABR’s preference is to spell out any terms that might be unfamiliar to candidates, spelling out commonly used terms can distract an examinee from the intent of the question. Committee members weigh these considerations when evaluating each acronym. Because the ABR aims to exclude trade names whenever possible, vendor-specific terminology is also reviewed, and the committee determines the most appropriate terms to use when referring to technology and imaging parameters.

The LSC recently recommended new standards related to sex and gender terminology, advising that it should only be used when such details are necessary for an examinee to arrive at a correct answer. Otherwise, gender-neutral alternatives should be used. This approach aligns with efforts to exclude extraneous details that do not contribute to evaluating a candidate’s knowledge and competency. The multidisciplinary group meets regularly to assess and set standards for how items are phrased and presented while being mindful of ongoing changes in medical terminology and technology.

The Language and Style Committee’s work and new item writer orientations are integral to the ABR’s dedication to continually improving exam quality. With a vast network of item writers nationwide, providing guidelines, thoughtful orientations, and ongoing feedback to item writers is critical to creating exams that are consistent across disciplines, with language that is straightforward and easily understandable.

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