Donald Melnick, MD

Donald Melnick is Senior Vice President and Director, Division of Research and Development, at the National Board of Medical Examiners. A 1971 graduate of Columbia Union College in chemistry and German, he earned an MD from Loma Linda University in 1974. After a year as a Medical Assistance Program Fellow in Southeast Asia, he completed post-graduate training in General Internal Medicine at the Medical Center Hospital of Vermont, where he was an experimental subject as a user of the PROMIS electronic medical record system. He joined the faculty of Marshall University School of Medicine in 1978 as Assistant then Associate Professor of Pharmacology and Internal Medicine. He led the Section of General Internal Medicine at Marshall from 1979-1983. Concurrently, he served as Medical Director of John Marshall Medical Services, a multi-specialty faculty group practice. In this capacity, he adapted computer systems designed for business support to provide instructional information about their patients for students and residents. In 1983, he joined the staff of the National Board of Medical Examiners as Senior Medical Evaluation Officer to lead the Computer Based Examination (CBX) project. This project envisioned computer delivery of traditional multiple-choice question examinations, but, more importantly, developed a computer-based patient management simulation for assessment of doctorsí patient management skills. The CBX simulation included free text entry in a simulated order sheet and provided time-realistic evolution of the patientís disease course, appropriately responding to the interventions of the test taker. The system utilized videodisc images displayed by the simulation to present radiographs, microscopic images, electrocardiograms, and other relevant medical images. He worked with Bell Laboratories to develop this technology, including the digitization of radiographs to allow image manipulation by the user. Later renamed Primum, the CBX simulation system was targeted for use in Part III of the NBME Certifying Examination program. Because of delays in the availability of an appropriate delivery system, implementation of this system was delayed beyond its anticipated 1988 start date. However, the CBX simulation programs were provided to more the 50 US medical schools for use in formative assessment. The system will be implemented in the national licensing examination program as soon as an adequate computer-based testing delivery system is available. During his tenure at the NBME, he has also served in an adjunct faculty role, providing resident and student supervision at Hahnemann University School of Medicine and the University of Pennsylvania School of Medicine. He has been active in the American Society for Clinical Pharmacology and Therapeutics, American College of Physicians, the Society for General Internal Medicine, the American College of Physician Executives, and AMIA. He has been a regular participant at SCAMC, with a major plenary presentation on the CBX project at the 1987 SCAMC conference. His publications have appeared both in pharmacology and medical informatics journals. Since completion of the CBX project, he has moved to lead the NBMEís research initiatives more broadly, including continued development of the computer-based examination program as well as work on assessment of clinical skills using standardized patients.