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American Board of Dermatology Template for Self-Assessment Exercises
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ABD Template for Self-Assessment Exercises SELF ASSESSMENT EXERCISE DETAILS (to be completed by applicant) Items Submitted By: Number of Items submitted in this template: Did you submit additional items on another template? The ABD designed this template to facilitate the submission of self-assessment questions for review. Using this template is not required. However, all items used in a self-assessment exercise for MOC Part II credit must conform to the ABD standards and include all of the following elements: Stem 5 answer options Correct answer designation Discussion /Item Critique (in narrative or bullet point format) References This template is designed to collect details for up to 100 items. If your exercise exceeds 100 items, use additional copies of this template.
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QUESTION 1 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 1 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 2 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 2 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 3 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 3 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 4 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 4 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 5 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 6 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 8 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 9 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 10 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 11 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 12 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 12 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 13 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 13 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 14 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 14 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 15 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 15 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 16 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 16 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 17 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 17 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 18 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 18 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 19 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 20 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 21 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 22 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 23 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 24 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 24 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 25 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 25 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 26 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 28 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 30 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 32 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 33 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 33 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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QUESTION 34 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 35 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 37 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 38 IMAGE (optional): STEM: A: B: C: D: E: CORRECT RESPONSE:
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QUESTION 38 DISCUSSION/ITEM CRITIQUE: REFERENCES:
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