Ensuring the quality of multiple-choice exams administered to small cohorts: A cautionary tale
Introduction Multiple-choice questions (MCQs) are a cornerstone of assessment in medical education. Monitoring item properties (difficulty and discrimination) are important means of investigating examination quality. However, most item property guidelines were developed for use on large cohorts of e...
Ausführliche Beschreibung
Autor*in: |
Young, Meredith [verfasserIn] Cummings, Beth-Ann [verfasserIn] St-Onge, Christina [verfasserIn] |
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E-Artikel |
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Englisch |
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2017 |
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Enthalten in: Perspectives on medical education - Houten : Bohn Stafleu van Loghum, 2012, 6(2017), 1 vom: 03. Jan., Seite 21-28 |
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Übergeordnetes Werk: |
volume:6 ; year:2017 ; number:1 ; day:03 ; month:01 ; pages:21-28 |
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DOI / URN: |
10.1007/s40037-016-0322-0 |
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SPR032686927 |
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520 | |a Introduction Multiple-choice questions (MCQs) are a cornerstone of assessment in medical education. Monitoring item properties (difficulty and discrimination) are important means of investigating examination quality. However, most item property guidelines were developed for use on large cohorts of examinees; little empirical work has investigated the suitability of applying guidelines to item difficulty and discrimination coefficients estimated for small cohorts, such as those in medical education. We investigated the extent to which item properties vary across multiple clerkship cohorts to better understand the appropriateness of using such guidelines with small cohorts. Methods Exam results for 32 items from an MCQ exam were used. Item discrimination and difficulty coefficients were calculated for 22 cohorts (n = 10–15 students). Discrimination coefficients were categorized according to Ebel and Frisbie (1991). Difficulty coefficients were categorized according to three guidelines by Laveault and Grégoire (2014). Descriptive analyses examined variance in item properties across cohorts. Results A large amount of variance in item properties was found across cohorts. Discrimination coefficients for items varied greatly across cohorts, with 29/32 (91%) of items occurring in both Ebel and Frisbie’s ‘poor’ and ‘excellent’ categories and 19/32 (59%) of items occurring in all five categories. For item difficulty coefficients, the application of different guidelines resulted in large variations in examination length (number of items removed ranged from 0 to 22). Discussion While the psychometric properties of items can provide information on item and exam quality, they vary greatly in small cohorts. The application of guidelines with small exam cohorts should be approached with caution. | ||
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10.1007/s40037-016-0322-0 doi (DE-627)SPR032686927 (SPR)s40037-016-0322-0-e DE-627 ger DE-627 rakwb eng 610 ASE Young, Meredith verfasserin aut Ensuring the quality of multiple-choice exams administered to small cohorts: A cautionary tale 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Multiple-choice questions (MCQs) are a cornerstone of assessment in medical education. Monitoring item properties (difficulty and discrimination) are important means of investigating examination quality. However, most item property guidelines were developed for use on large cohorts of examinees; little empirical work has investigated the suitability of applying guidelines to item difficulty and discrimination coefficients estimated for small cohorts, such as those in medical education. We investigated the extent to which item properties vary across multiple clerkship cohorts to better understand the appropriateness of using such guidelines with small cohorts. Methods Exam results for 32 items from an MCQ exam were used. Item discrimination and difficulty coefficients were calculated for 22 cohorts (n = 10–15 students). Discrimination coefficients were categorized according to Ebel and Frisbie (1991). Difficulty coefficients were categorized according to three guidelines by Laveault and Grégoire (2014). Descriptive analyses examined variance in item properties across cohorts. Results A large amount of variance in item properties was found across cohorts. Discrimination coefficients for items varied greatly across cohorts, with 29/32 (91%) of items occurring in both Ebel and Frisbie’s ‘poor’ and ‘excellent’ categories and 19/32 (59%) of items occurring in all five categories. For item difficulty coefficients, the application of different guidelines resulted in large variations in examination length (number of items removed ranged from 0 to 22). Discussion While the psychometric properties of items can provide information on item and exam quality, they vary greatly in small cohorts. The application of guidelines with small exam cohorts should be approached with caution. Item properties (dpeaa)DE-He213 Assessment (dpeaa)DE-He213 Multiple-choice examination (dpeaa)DE-He213 Cummings, Beth-Ann verfasserin aut St-Onge, Christina verfasserin aut Enthalten in Perspectives on medical education Houten : Bohn Stafleu van Loghum, 2012 6(2017), 1 vom: 03. Jan., Seite 21-28 (DE-627)719410169 (DE-600)2670231-9 2212-277X nnns volume:6 year:2017 number:1 day:03 month:01 pages:21-28 https://dx.doi.org/10.1007/s40037-016-0322-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2017 1 03 01 21-28 |
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10.1007/s40037-016-0322-0 doi (DE-627)SPR032686927 (SPR)s40037-016-0322-0-e DE-627 ger DE-627 rakwb eng 610 ASE Young, Meredith verfasserin aut Ensuring the quality of multiple-choice exams administered to small cohorts: A cautionary tale 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Multiple-choice questions (MCQs) are a cornerstone of assessment in medical education. Monitoring item properties (difficulty and discrimination) are important means of investigating examination quality. However, most item property guidelines were developed for use on large cohorts of examinees; little empirical work has investigated the suitability of applying guidelines to item difficulty and discrimination coefficients estimated for small cohorts, such as those in medical education. We investigated the extent to which item properties vary across multiple clerkship cohorts to better understand the appropriateness of using such guidelines with small cohorts. Methods Exam results for 32 items from an MCQ exam were used. Item discrimination and difficulty coefficients were calculated for 22 cohorts (n = 10–15 students). Discrimination coefficients were categorized according to Ebel and Frisbie (1991). Difficulty coefficients were categorized according to three guidelines by Laveault and Grégoire (2014). Descriptive analyses examined variance in item properties across cohorts. Results A large amount of variance in item properties was found across cohorts. Discrimination coefficients for items varied greatly across cohorts, with 29/32 (91%) of items occurring in both Ebel and Frisbie’s ‘poor’ and ‘excellent’ categories and 19/32 (59%) of items occurring in all five categories. For item difficulty coefficients, the application of different guidelines resulted in large variations in examination length (number of items removed ranged from 0 to 22). Discussion While the psychometric properties of items can provide information on item and exam quality, they vary greatly in small cohorts. The application of guidelines with small exam cohorts should be approached with caution. Item properties (dpeaa)DE-He213 Assessment (dpeaa)DE-He213 Multiple-choice examination (dpeaa)DE-He213 Cummings, Beth-Ann verfasserin aut St-Onge, Christina verfasserin aut Enthalten in Perspectives on medical education Houten : Bohn Stafleu van Loghum, 2012 6(2017), 1 vom: 03. Jan., Seite 21-28 (DE-627)719410169 (DE-600)2670231-9 2212-277X nnns volume:6 year:2017 number:1 day:03 month:01 pages:21-28 https://dx.doi.org/10.1007/s40037-016-0322-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2017 1 03 01 21-28 |
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10.1007/s40037-016-0322-0 doi (DE-627)SPR032686927 (SPR)s40037-016-0322-0-e DE-627 ger DE-627 rakwb eng 610 ASE Young, Meredith verfasserin aut Ensuring the quality of multiple-choice exams administered to small cohorts: A cautionary tale 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Multiple-choice questions (MCQs) are a cornerstone of assessment in medical education. Monitoring item properties (difficulty and discrimination) are important means of investigating examination quality. However, most item property guidelines were developed for use on large cohorts of examinees; little empirical work has investigated the suitability of applying guidelines to item difficulty and discrimination coefficients estimated for small cohorts, such as those in medical education. We investigated the extent to which item properties vary across multiple clerkship cohorts to better understand the appropriateness of using such guidelines with small cohorts. Methods Exam results for 32 items from an MCQ exam were used. Item discrimination and difficulty coefficients were calculated for 22 cohorts (n = 10–15 students). Discrimination coefficients were categorized according to Ebel and Frisbie (1991). Difficulty coefficients were categorized according to three guidelines by Laveault and Grégoire (2014). Descriptive analyses examined variance in item properties across cohorts. Results A large amount of variance in item properties was found across cohorts. Discrimination coefficients for items varied greatly across cohorts, with 29/32 (91%) of items occurring in both Ebel and Frisbie’s ‘poor’ and ‘excellent’ categories and 19/32 (59%) of items occurring in all five categories. For item difficulty coefficients, the application of different guidelines resulted in large variations in examination length (number of items removed ranged from 0 to 22). Discussion While the psychometric properties of items can provide information on item and exam quality, they vary greatly in small cohorts. The application of guidelines with small exam cohorts should be approached with caution. Item properties (dpeaa)DE-He213 Assessment (dpeaa)DE-He213 Multiple-choice examination (dpeaa)DE-He213 Cummings, Beth-Ann verfasserin aut St-Onge, Christina verfasserin aut Enthalten in Perspectives on medical education Houten : Bohn Stafleu van Loghum, 2012 6(2017), 1 vom: 03. Jan., Seite 21-28 (DE-627)719410169 (DE-600)2670231-9 2212-277X nnns volume:6 year:2017 number:1 day:03 month:01 pages:21-28 https://dx.doi.org/10.1007/s40037-016-0322-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2017 1 03 01 21-28 |
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10.1007/s40037-016-0322-0 doi (DE-627)SPR032686927 (SPR)s40037-016-0322-0-e DE-627 ger DE-627 rakwb eng 610 ASE Young, Meredith verfasserin aut Ensuring the quality of multiple-choice exams administered to small cohorts: A cautionary tale 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Multiple-choice questions (MCQs) are a cornerstone of assessment in medical education. Monitoring item properties (difficulty and discrimination) are important means of investigating examination quality. However, most item property guidelines were developed for use on large cohorts of examinees; little empirical work has investigated the suitability of applying guidelines to item difficulty and discrimination coefficients estimated for small cohorts, such as those in medical education. We investigated the extent to which item properties vary across multiple clerkship cohorts to better understand the appropriateness of using such guidelines with small cohorts. Methods Exam results for 32 items from an MCQ exam were used. Item discrimination and difficulty coefficients were calculated for 22 cohorts (n = 10–15 students). Discrimination coefficients were categorized according to Ebel and Frisbie (1991). Difficulty coefficients were categorized according to three guidelines by Laveault and Grégoire (2014). Descriptive analyses examined variance in item properties across cohorts. Results A large amount of variance in item properties was found across cohorts. Discrimination coefficients for items varied greatly across cohorts, with 29/32 (91%) of items occurring in both Ebel and Frisbie’s ‘poor’ and ‘excellent’ categories and 19/32 (59%) of items occurring in all five categories. For item difficulty coefficients, the application of different guidelines resulted in large variations in examination length (number of items removed ranged from 0 to 22). Discussion While the psychometric properties of items can provide information on item and exam quality, they vary greatly in small cohorts. The application of guidelines with small exam cohorts should be approached with caution. Item properties (dpeaa)DE-He213 Assessment (dpeaa)DE-He213 Multiple-choice examination (dpeaa)DE-He213 Cummings, Beth-Ann verfasserin aut St-Onge, Christina verfasserin aut Enthalten in Perspectives on medical education Houten : Bohn Stafleu van Loghum, 2012 6(2017), 1 vom: 03. Jan., Seite 21-28 (DE-627)719410169 (DE-600)2670231-9 2212-277X nnns volume:6 year:2017 number:1 day:03 month:01 pages:21-28 https://dx.doi.org/10.1007/s40037-016-0322-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2017 1 03 01 21-28 |
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10.1007/s40037-016-0322-0 doi (DE-627)SPR032686927 (SPR)s40037-016-0322-0-e DE-627 ger DE-627 rakwb eng 610 ASE Young, Meredith verfasserin aut Ensuring the quality of multiple-choice exams administered to small cohorts: A cautionary tale 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Multiple-choice questions (MCQs) are a cornerstone of assessment in medical education. Monitoring item properties (difficulty and discrimination) are important means of investigating examination quality. However, most item property guidelines were developed for use on large cohorts of examinees; little empirical work has investigated the suitability of applying guidelines to item difficulty and discrimination coefficients estimated for small cohorts, such as those in medical education. We investigated the extent to which item properties vary across multiple clerkship cohorts to better understand the appropriateness of using such guidelines with small cohorts. Methods Exam results for 32 items from an MCQ exam were used. Item discrimination and difficulty coefficients were calculated for 22 cohorts (n = 10–15 students). Discrimination coefficients were categorized according to Ebel and Frisbie (1991). Difficulty coefficients were categorized according to three guidelines by Laveault and Grégoire (2014). Descriptive analyses examined variance in item properties across cohorts. Results A large amount of variance in item properties was found across cohorts. Discrimination coefficients for items varied greatly across cohorts, with 29/32 (91%) of items occurring in both Ebel and Frisbie’s ‘poor’ and ‘excellent’ categories and 19/32 (59%) of items occurring in all five categories. For item difficulty coefficients, the application of different guidelines resulted in large variations in examination length (number of items removed ranged from 0 to 22). Discussion While the psychometric properties of items can provide information on item and exam quality, they vary greatly in small cohorts. The application of guidelines with small exam cohorts should be approached with caution. Item properties (dpeaa)DE-He213 Assessment (dpeaa)DE-He213 Multiple-choice examination (dpeaa)DE-He213 Cummings, Beth-Ann verfasserin aut St-Onge, Christina verfasserin aut Enthalten in Perspectives on medical education Houten : Bohn Stafleu van Loghum, 2012 6(2017), 1 vom: 03. Jan., Seite 21-28 (DE-627)719410169 (DE-600)2670231-9 2212-277X nnns volume:6 year:2017 number:1 day:03 month:01 pages:21-28 https://dx.doi.org/10.1007/s40037-016-0322-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2017 1 03 01 21-28 |
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ensuring the quality of multiple-choice exams administered to small cohorts: a cautionary tale |
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Ensuring the quality of multiple-choice exams administered to small cohorts: A cautionary tale |
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Introduction Multiple-choice questions (MCQs) are a cornerstone of assessment in medical education. Monitoring item properties (difficulty and discrimination) are important means of investigating examination quality. However, most item property guidelines were developed for use on large cohorts of examinees; little empirical work has investigated the suitability of applying guidelines to item difficulty and discrimination coefficients estimated for small cohorts, such as those in medical education. We investigated the extent to which item properties vary across multiple clerkship cohorts to better understand the appropriateness of using such guidelines with small cohorts. Methods Exam results for 32 items from an MCQ exam were used. Item discrimination and difficulty coefficients were calculated for 22 cohorts (n = 10–15 students). Discrimination coefficients were categorized according to Ebel and Frisbie (1991). Difficulty coefficients were categorized according to three guidelines by Laveault and Grégoire (2014). Descriptive analyses examined variance in item properties across cohorts. Results A large amount of variance in item properties was found across cohorts. Discrimination coefficients for items varied greatly across cohorts, with 29/32 (91%) of items occurring in both Ebel and Frisbie’s ‘poor’ and ‘excellent’ categories and 19/32 (59%) of items occurring in all five categories. For item difficulty coefficients, the application of different guidelines resulted in large variations in examination length (number of items removed ranged from 0 to 22). Discussion While the psychometric properties of items can provide information on item and exam quality, they vary greatly in small cohorts. The application of guidelines with small exam cohorts should be approached with caution. |
abstractGer |
Introduction Multiple-choice questions (MCQs) are a cornerstone of assessment in medical education. Monitoring item properties (difficulty and discrimination) are important means of investigating examination quality. However, most item property guidelines were developed for use on large cohorts of examinees; little empirical work has investigated the suitability of applying guidelines to item difficulty and discrimination coefficients estimated for small cohorts, such as those in medical education. We investigated the extent to which item properties vary across multiple clerkship cohorts to better understand the appropriateness of using such guidelines with small cohorts. Methods Exam results for 32 items from an MCQ exam were used. Item discrimination and difficulty coefficients were calculated for 22 cohorts (n = 10–15 students). Discrimination coefficients were categorized according to Ebel and Frisbie (1991). Difficulty coefficients were categorized according to three guidelines by Laveault and Grégoire (2014). Descriptive analyses examined variance in item properties across cohorts. Results A large amount of variance in item properties was found across cohorts. Discrimination coefficients for items varied greatly across cohorts, with 29/32 (91%) of items occurring in both Ebel and Frisbie’s ‘poor’ and ‘excellent’ categories and 19/32 (59%) of items occurring in all five categories. For item difficulty coefficients, the application of different guidelines resulted in large variations in examination length (number of items removed ranged from 0 to 22). Discussion While the psychometric properties of items can provide information on item and exam quality, they vary greatly in small cohorts. The application of guidelines with small exam cohorts should be approached with caution. |
abstract_unstemmed |
Introduction Multiple-choice questions (MCQs) are a cornerstone of assessment in medical education. Monitoring item properties (difficulty and discrimination) are important means of investigating examination quality. However, most item property guidelines were developed for use on large cohorts of examinees; little empirical work has investigated the suitability of applying guidelines to item difficulty and discrimination coefficients estimated for small cohorts, such as those in medical education. We investigated the extent to which item properties vary across multiple clerkship cohorts to better understand the appropriateness of using such guidelines with small cohorts. Methods Exam results for 32 items from an MCQ exam were used. Item discrimination and difficulty coefficients were calculated for 22 cohorts (n = 10–15 students). Discrimination coefficients were categorized according to Ebel and Frisbie (1991). Difficulty coefficients were categorized according to three guidelines by Laveault and Grégoire (2014). Descriptive analyses examined variance in item properties across cohorts. Results A large amount of variance in item properties was found across cohorts. Discrimination coefficients for items varied greatly across cohorts, with 29/32 (91%) of items occurring in both Ebel and Frisbie’s ‘poor’ and ‘excellent’ categories and 19/32 (59%) of items occurring in all five categories. For item difficulty coefficients, the application of different guidelines resulted in large variations in examination length (number of items removed ranged from 0 to 22). Discussion While the psychometric properties of items can provide information on item and exam quality, they vary greatly in small cohorts. The application of guidelines with small exam cohorts should be approached with caution. |
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