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Differential weighting of errors on a test of clinical reasoning skills
Ruth A Childs1, Jennifer L Dunn, Christina Van Barneveld
1Ontario Institute for Studies in Education of the University of Toronto, Canada. rchilds@oise.utoronto.ca
Problem Statement And Background:
Examinees can make three types of errors on the short-menu questions in the Clinical Reasoning Skills component of the Medical Council of Canada's Qualifying Examination Part I: (1) failing to select any correct responses, (2) selecting too many responses, or (3) selecting a response that is inappropriate or harmful to the patient. This study compared the information provided by equal and differential weighting of these errors.
Method:
The item response theory nominal model was applied to fit examinees' response patterns on the 1998 test.
Results:
Differential error weighting resulted in improved model fit and increased test information for examinees in the lower half of the achievement continuum.
Conclusion:
Differential error weighting appears promising. The pass score is near the lower end of the achievement continuum; therefore, this approach may improve the accuracy of pass-fail decisions.
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