Specialization – ABC CARDIOL

ABC

Original Article

Psychometric Evaluation of the Cardiology Certification Exam of the Brazilian Society of Cardiology

Gustavo Eugênio Martins Marinho et al. José Maria Peixoto José Knopfholz Marcus Vinicius Santos Andrade

Abstract

Background

The Cardiology Certification Exam is issued annually by the Brazilian Cardiology Society and set and applied by the Judging Committee for the Cardiologist Title (CJTEC). The psychometric analysis of the exam items using the Item Response Theory (IRT) may provide robust data that can help in the continuous improvement of this instrument.

Objectives

To evaluate the psychometric properties of the 2019 Cardiology Certification Exam in relation to the IR parameters.

Methods

This was an observational study, with psychometric analysis of the 120 questions of the exam taken by 1,120 candidates for the title of Cardiologist in 2019.

Results

The IRT analysis revealed that 32.2% of the items had a “high” or “very high” discriminating power, 49.2% were categorized as “easy” or “very easy”, and 41.5% showed a high probability of a correct guessing. Sixty-nine deficient items in terms of the IRT parameters were identified, which were then considered poorly effective in evaluating the candidate’s ability.

Conclusions

The psychometric analysis of the 2019 Cardiology Certification Exam by the IRT revealed a high percentage of easy questions, with nearly two thirds of the items with a high probability of correct guessing. These data may serve as a basis for a series of discussions and proposals for the elaboration of future certificate exams in Cardiology.

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ABCHF

Editorial

The Role of the Heart Failure Specialist: Benefits for Both the Patient and the Cardiology Community

Livia A. Goldraich et al. Jefferson L. Vieira Nadine Clausell

In recent decades, the advancement of knowledge of cardiovascular diseases has been remarkable. Heart failure (HF) has a prominent role among the conditions of greatest epidemiological relevance for the population, given its high prevalence and incidence worldwide, including Brazil.^– Thus, mastery of this condition is key to cardiologist training. However, the understanding of the complexity of the different diseases and pathophysiological mechanisms potentially involved in the development, progression, and prognosis of HF has advanced, and a broad and intricate spectrum of therapeutic options has emerged, especially in the past two decades. These advances allowed a significant improvement in the clinical outcomes of HF patients; however, as knowledge and consequent therapeutic challenges became more complex, it was clear that a new type of training and expertise in the field of Cardiology was needed.

The American Heart Association (AHA) and the European Society of Cardiology (ESC) were the first to encourage the growth and strengthening of the HF specialty, with the creation of study groups, departments, and journals focused on this condition.^– Several specific HF congresses have been organized and brought together a growing number of participants for about 20 years. Concomitantly, several cardiology centers of worldwide relevance have developed fellowship programs in HF and heart transplantation, many of which more recently also cover mechanical circulatory support. Finally, certification examinations for HF specialist by the American Board of Internal Medicine (ABIM) and the ESC Heart Failure Association were created in 2013 and 2014, respectively.^, In 2020, an expert consensus of the American College of Cardiology (ACC) together with the Heart Failure Society of America (HFSA) and the International Society for Heart and Lung Transplantation (ISHLT) introduced a list of requirements for HF specialist training, based on the core competencies of the Accreditation Council for Graduate Medical Education (ACGME). This document outlines, in particular, the expectations for physicians who treat advanced HF patients or heart transplant recipients, and recommends specific skills in mechanical circulatory support, cardiac resynchronization therapy, heart transplantation, and pulmonary hypertension. The authors also recommend that there be a maintenance of certification process based on participation in continuing medical education programs and collaboration with national databases and registries. exemplifies and adapts the HF training model used at Brigham and Women’s Hospital, Harvard University, Boston, United States.

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