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Renes J, van der Vleuten CPM, Collares CF. Utility of a multimodal computer-based assessment format for assessment with a higher degree of reliability and validity. Med Teach 2023; 45:433-441. [PMID: 36306368 DOI: 10.1080/0142159x.2022.2137011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Multiple choice questions (MCQs) suffer from cueing, item quality and factual knowledge testing. This study presents a novel multimodal test containing alternative item types in a computer-based assessment (CBA) format, designated as Proxy-CBA. The Proxy-CBA was compared to a standard MCQ-CBA, regarding validity, reliability, standard error of measurement, and cognitive load, using a quasi-experimental crossover design. Biomedical students were randomized into two groups to sit a 65-item formative exam starting with the MCQ-CBA followed by the Proxy-CBA (group 1, n = 38), or the reverse (group 2, n = 35). Subsequently, a questionnaire on perceived cognitive load was taken, answered by 71 participants. Both CBA formats were analyzed according to parameters of the Classical Test Theory and the Rasch model. Compared to the MCQ-CBA, the Proxy-CBA had lower raw scores (p < 0.001, η2 = 0.276), higher reliability estimates (p < 0.001, η2 = 0.498), lower SEM estimates (p < 0.001, η2 = 0.807), and lower theta ability scores (p < 0.001, η2 = 0.288). The questionnaire revealed no significant differences between both CBA tests regarding perceived cognitive load. Compared to the MCQ-CBA, the Proxy-CBA showed increased reliability and a higher degree of validity with similar cognitive load, suggesting its utility as an alternative assessment format.
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Affiliation(s)
- Johan Renes
- Department of Human Biology, Maastricht University, The Netherlands
| | - Cees P M van der Vleuten
- Department of Educational Research and Development, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Carlos F Collares
- Department of Educational Research and Development, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- European Board of Medical Assessors, Edinburgh, UK
- Stichting Aphasia.help, Maastricht, The Netherlands
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Gentile M, Melovitz-Vasan C, Huff S, Vasan N. The Utilization of ExamSoft®-iPad® Technology in Administering and Grading Anatomy Practical Examinations. Med Sci Educ 2019; 29:831-840. [PMID: 34457548 PMCID: PMC8368944 DOI: 10.1007/s40670-019-00750-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This article provides a detailed, step-by-step description of the introduction of technology (iPad® use of ExamSoft® web-based assessment software) for administering and grading cadaver-oriented anatomy practical examinations. We explain the advantages of computer-based testing in the delivery and grading of practical examinations, including minimizing human error inherent in hand grading, improving the efficiency of reporting, and mapping the examination to course objectives. Furthermore, item analysis (including item difficulty, discrimination indices, and point biserial correlations) allows evaluation of laboratory teaching and testing and monitoring of the curriculum. We also address how the advantages of this format override any limitation, such as cost. In conclusion, we describe our future directions and how others could adopt this approach.
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Affiliation(s)
- Matthew Gentile
- Office of Medical Education, Cooper Medical School of Rowan University, Camden, NJ USA
| | - Cheryl Melovitz-Vasan
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, 401 South Broadway, Camden, 08103 USA
| | - Susan Huff
- Office of Medical Education, Cooper Medical School of Rowan University, Camden, NJ USA
| | - Nagaswami Vasan
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, 401 South Broadway, Camden, 08103 USA
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Cerutti B, Stollar F, Escher M, Blondon K, Aujesky S, Nendaz M, Galetto-Lacour A. Comparison of long-menu and single-best-answer multiple choice questions in computer-based summative assessments: a randomised controlled trial. BMC Med Educ 2019; 19:219. [PMID: 31215430 PMCID: PMC6582573 DOI: 10.1186/s12909-019-1651-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/06/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Little is known regarding the psychometric properties of computerized long-menu formats in comparison to classic formats. We compared single-best-answer (Type A) and long-menu formats using identical question stems during the computer-based, summative, intermediate clinical-clerkship exams for nine disciplines. METHODS In this randomised sequential trial, we assigned the examinees for every summative exam to either the Type A or long-menu format (four different experimental questions, otherwise identical). The primary outcome was the power of discrimination. The study was carried out at the Faculty of Medicine, University of Geneva, Switzerland, and included all the students enrolled for the exams that were part of the study. Examinees were surveyed about the long-menu format at the end of the trial. RESULTS The trial was stopped for futility (p = 0.7948) after 22 exams including 88 experimental items. The long-menu format had a similar discriminatory power but was more difficult than the Type A format (71.45% vs 77.80%; p = 0.0001). Over half of the options (54.4%) chosen by the examinees in long-menu formats were not proposed as distractors in the Type A formats. Most examinees agreed that their reasoning strategy was different. CONCLUSIONS In a non-selected population of examinees taking summative exams, long-menu questions have the same discriminatory power as classic Type A questions, but they are slightly more difficult. They are perceived to be closer to real practice, which could have a positive educational impact. We would recommend their use in the final years of the curriculum, within realistic key-feature problems, to assess clinical reasoning and patient management skills.
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Affiliation(s)
- Bernard Cerutti
- Unit of Development and Research in Medical Education, Faculty of medicine, Faculty of medicine, 1 Rue Michel Servet, 1211 Geneva 4, Switzerland
| | - Fabiola Stollar
- Department of Paediatrics, Children’s Hospital, University Hospitals of Geneva, Geneva, Switzerland
| | - Monica Escher
- Unit of Development and Research in Medical Education, Faculty of medicine, Faculty of medicine, 1 Rue Michel Servet, 1211 Geneva 4, Switzerland
- Division of Palliative Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Katherine Blondon
- Medical Directorate of the University Hospitals of Geneva, Geneva, Switzerland
| | - Susanne Aujesky
- Department of Paediatrics, Children’s Hospital, University Hospitals of Geneva, Geneva, Switzerland
| | - Mathieu Nendaz
- Unit of Development and Research in Medical Education, Faculty of medicine, Faculty of medicine, 1 Rue Michel Servet, 1211 Geneva 4, Switzerland
| | - Annick Galetto-Lacour
- Department of Paediatrics, Children’s Hospital, University Hospitals of Geneva, Geneva, Switzerland
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Myers S, Hojjat S, Miller R, Bruer S, Ferrone M. Development of a student-driven information technology support service. Curr Pharm Teach Learn 2018; 10:1391-1405. [PMID: 30527369 DOI: 10.1016/j.cptl.2018.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 06/02/2018] [Accepted: 07/09/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND PURPOSE To share our experience of a partnership created amongst students, staff, and faculty in order to address a gap in campus information technology (IT) customer services provided to students. EDUCATIONAL ACTIVITY AND SETTING Student reliance on a complex educational technology ecosystem requires a robust IT infrastructure; however, campus IT services are often stretched in terms of their capacity to deliver immediate customer support. Compounding this problem is the inability of campus IT services to address issues arising from pharmacy education specific hardware or software. A student help desk (SHD), a student-initiated technology user group was developed. The support provided by the SHD covers student devices to the level of ensuring access to required curriculum technological resources. FINDINGS Over 24 months, a total of 259 cases were addressed by the SHD. When examining the type of submissions, the top five requested categories included computer-based assessment, e-mail synchronization, curricular management software synchronization, wireless printing and encryption. These results suggest the perceived value and confidence by students and faculty in the service provided by the SHD. SUMMARY The use of a SHD helped to resolve technology issues faced by students for curriculum engagement. Regardless of the challenges institutions may face in delivering their curriculum, students have the desire to be engaged in the governance of their curriculum. By creating a collaborative triad, this represents one example of how student motivation can be leveraged to conquer not just gaps in IT customer service, but potentially other programmatic issues within an institution.
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Affiliation(s)
- Scott Myers
- University of California, San Francisco, School of Pharmacy, 513 Parnassus Ave Rm 924, Box 0150, San Francisco, CA 94143, United States.
| | - Sahar Hojjat
- University of California, San Francisco, School of Pharmacy, 513 Parnassus Ave Rm 924, Box 0150, San Francisco, CA 94143, United States.
| | - Rebecca Miller
- University of California, San Francisco, School of Pharmacy, 513 Parnassus Ave Rm 924, Box 0150, San Francisco, CA 94143, United States.
| | - Stephen Bruer
- University of California, San Francisco, School of Pharmacy, 513 Parnassus Ave Rm 924, Box 0150, San Francisco, CA 94143, United States.
| | - Marcus Ferrone
- University of California, San Francisco, School of Pharmacy, 3333 California Street, Suite 420, Box 0613, San Francisco, CA 94118, United States.
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Adde L, Thomas N, John HB, Oommen S, Vågen RT, Fjørtoft T, Jensenius AR, Støen R. Early motor repertoire in very low birth weight infants in India is associated with motor development at one year. Eur J Paediatr Neurol 2016; 20:918-924. [PMID: 27524392 DOI: 10.1016/j.ejpn.2016.07.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 05/04/2016] [Accepted: 07/22/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Most studies on Prechtl's method of assessing General Movements (GMA) in young infants originate in Europe. AIM To determine if motor behavior at an age of 3 months post term is associated with motor development at 12 months post age in VLBW infants in India. METHODS 243 VLBW infants (135 boys, 108 girls; median gestational age 31wks, range 26-39wks) were video-recorded at a median age of 11wks post term (range 9-16wks). Certified and experienced observers assessed the videos by the "Assessment of Motor Repertoire - 2-5 Months". Fidgety movements (FMs) were classified as abnormal if absent, sporadic or exaggerated, and as normal if intermittently or continually present. The motor behaviour was evaluated by repertoire of co-existent other movements (age-adequacy) and concurrent motor repertoire. In addition, videos of 215 infants were analyzed by computer and the variability of the spatial center of motion (CSD) was calculated. The Peabody Developmental Motor Scales was used to assess motor development at 12 months. RESULTS Abnormal FMs, reduced age adequacy, and an abnormal concurrent motor repertoire were significantly associated with lower Gross Motor and Total Motor Quotient (GMQ, TMQ) scores (p < 0.05). The CSD was higher in children with TMQ scores <90 (-1SD) than in children with higher TMQ scores (p = 0.002). CONCLUSION Normal FMs (assessed by Gestalt perception) and a low variability of the spatial center of motion (assessed by computer-based video analysis) predicted higher Peabody scores in 12-month-old infants born in India with a very low birth weight.
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Affiliation(s)
- Lars Adde
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway; Department of Physiotherapy, Clinic of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, P.O. Box 3250 Sluppen, 7006 Trondheim, Norway.
| | - Niranjan Thomas
- Department of Neonatology, Christian Medical College, IDA Scudder Rd, Vellore, Tamil Nadu 632004, India.
| | - Hima B John
- Department of Neonatology, Christian Medical College, IDA Scudder Rd, Vellore, Tamil Nadu 632004, India.
| | - Samuel Oommen
- Department of Neonatology, Christian Medical College, IDA Scudder Rd, Vellore, Tamil Nadu 632004, India.
| | - Randi Tynes Vågen
- Department of Physiotherapy, Clinic of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, P.O. Box 3250 Sluppen, 7006 Trondheim, Norway.
| | - Toril Fjørtoft
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway; Department of Physiotherapy, Clinic of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, P.O. Box 3250 Sluppen, 7006 Trondheim, Norway.
| | | | - Ragnhild Støen
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway; Department of Pediatrics, St. Olavs Hospital, Trondheim University Hospital, P.O. Box 3250 Sluppen, 7006 Trondheim, Norway.
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Kiessling C, Bauer J, Gartmeier M, Iblher P, Karsten G, Kiesewetter J, Moeller GE, Wiesbeck A, Zupanic M, Fischer MR. Development and validation of a computer-based situational judgement test to assess medical students' communication skills in the field of shared decision making. Patient Educ Couns 2016; 99:1858-1864. [PMID: 27345253 DOI: 10.1016/j.pec.2016.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 05/27/2016] [Accepted: 06/12/2016] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To develop a computer-based test (CBT) measuring medical students' communication skills in the field of shared decision making (SDM) and to evaluate its construct validity. METHODS The CBT was developed in the context of an experimental study comparing three different trainings for SDM (including e-learning and/or role-play) and a control group. Assessment included a CBT (Part A: seven context-poor questions, Part B: 15 context-rich questions) and interviews with two simulated patients (SP-assessment). Cronbach's α was used to test the internal consistency. Correlations between CBT and SP-assessment were used to further evaluate construct validity of the CBT. RESULTS Seventy-two students took part in the study. Mean value for the CBT score was 72% of the total score. Cronbach's α was 0.582. After eliminating three items, Cronbach's α increased to 0.625. Correlations between the CBT and SP-assessment were low to moderate. The control group scored significantly lower than the training settings (p<0.001). CONCLUSION The CBT was reliable enough to test for group differences. For summative assessment purposes, considerably more questions would be needed. PRACTICE IMPLICATIONS We encourage teachers who particularly work with large student numbers to consider CBT as a feasible assessment method for cognitive aspects of communication skills.
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Affiliation(s)
- Claudia Kiessling
- Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der Universität München, Germany; Assessment Department, Brandenburg Medical School Theodor Fontane, Germany.
| | - Johannes Bauer
- TUM School of Education, Technische Universität München, Germany
| | - Martin Gartmeier
- TUM School of Education, Technische Universität München, Germany
| | - Peter Iblher
- Department of Anesthesiology, Universitätsklinikum Schleswig-Holstein, Germany
| | - Gudrun Karsten
- Centre for Medical Education, Deańs Office of Education, Christian-Albrechts-Universität zu Kiel, Germany
| | - Jan Kiesewetter
- Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der Universität München, Germany
| | - Grit E Moeller
- Centre for Medical Education, Deańs Office of Education, Christian-Albrechts-Universität zu Kiel, Germany
| | - Anne Wiesbeck
- TUM School of Education, Technische Universität München, Germany
| | - Michaela Zupanic
- Office for Student Affairs, Fakultät für Gesundheit, Universität Witten/Herdecke, Germany
| | - Martin R Fischer
- Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der Universität München, Germany
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Kunina-Habenicht O, Hautz WE, Knigge M, Spies C, Ahlers O. Assessing clinical reasoning (ASCLIRE): Instrument development and validation. Adv Health Sci Educ Theory Pract 2015; 20:1205-1224. [PMID: 25725935 DOI: 10.1007/s10459-015-9596-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 02/19/2015] [Indexed: 06/04/2023]
Abstract
Clinical reasoning is an essential competency in medical education. This study aimed at developing and validating a test to assess diagnostic accuracy, collected information, and diagnostic decision time in clinical reasoning. A norm-referenced computer-based test for the assessment of clinical reasoning (ASCLIRE) was developed, integrating the entire clinical decision process. In a cross-sectional study participants were asked to choose as many diagnostic measures as they deemed necessary to diagnose the underlying disease of six different cases with acute or sub-acute dyspnea and provide a diagnosis. 283 students and 20 content experts participated. In addition to diagnostic accuracy, respective decision time and number of used relevant diagnostic measures were documented as distinct performance indicators. The empirical structure of the test was investigated using a structural equation modeling approach. Experts showed higher accuracy rates and lower decision times than students. In a cross-sectional comparison, the diagnostic accuracy of students improved with the year of study. Wrong diagnoses provided by our sample were comparable to wrong diagnoses in practice. We found an excellent fit for a model with three latent factors-diagnostic accuracy, decision time, and choice of relevant diagnostic information-with diagnostic accuracy showing no significant correlation with decision time. ASCLIRE considers decision time as an important performance indicator beneath diagnostic accuracy and provides evidence that clinical reasoning is a complex ability comprising diagnostic accuracy, decision time, and choice of relevant diagnostic information as three partly correlated but still distinct aspects.
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Affiliation(s)
- Olga Kunina-Habenicht
- Department of Educational Psychology, Institute of Psychology, Goethe-University Frankfurt, Theodor-W.-Adorno-Platz 6, 60629, Frankfurt am Main, Germany.
| | - Wolf E Hautz
- Department of Anesthesiology and Intensive Care Medicine CVK/CCM, Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany.
- Universitäres Notfallzentrum, Inselspital Bern, 3010, Bern, Switzerland.
| | - Michel Knigge
- Department Educational Science, Institute of Educational Psychology, Franckeplatz 1, 06099, Halle (Saale), Germany.
- Human Sciences Faculty, University of Potsdam, Karl-Liebknecht-Str. 24-25, Building 31, 14476, Potsdam, Germany.
| | - Claudia Spies
- Department of Anesthesiology and Intensive Care Medicine CVK/CCM, Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany.
| | - Olaf Ahlers
- Department of Anesthesiology and Intensive Care Medicine CVK/CCM, Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany.
- Department for Curriculum Management, Charité - Universitätsmedizin Berlin, 10117, Berlin, Germany.
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