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MCQ tests in Advanced Trauma Life Support (ATLS©): Development and revision
Jacqueline Bustraan1, Walter Henny2, John B Kortbeek3
1PLATO, Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands.
Injury
|December 22, 2015
Summary
The Advanced Trauma Life Support (ATLS) multiple-choice question (MCQ) tests were revised using evidence-based guidelines. While improving test quality, the revised ATLS tests led to a significant increase in student failure rates.
Area of Science:
- Medical Education
- Trauma Care Training
- Assessment Methodology
Background:
- Multiple-choice question (MCQ) tests are integral to assessing knowledge in Advanced Trauma Life Support (ATLS©) courses.
- The ninth Edition Revision Process involved an International MCQ Revision group reviewing and updating existing tests.
- The study aimed to evaluate the effectiveness and impact of this MCQ revision procedure.
Purpose of the Study:
- To assess the revision procedure for ATLS multiple-choice question tests.
- To determine the effects of revised MCQ tests on student knowledge assessment.
- To evaluate the psychometric properties and validity of updated ATLS assessment tools.
Main Methods:
- A stepwise approach based on psychometric data and evidence-based guidelines was used to evaluate and revise MCQs.
- Three new draft test versions (40 MCQs each) were created and beta-tested among ATLS Instructors.
- Psychometric analysis guided the revision and balancing of MCQ items to ensure test quality.
Main Results:
- Psychometric analysis indicated that a small number of MCQ items needed revision to create three equally balanced tests.
- Beta testing was conducted with instructors, not students, prior to implementation.
- A significant increase in the failure rate among students was observed after the introduction of the new MCQ tests.
Conclusions:
- ATLS tests were successfully revised and updated using evidence-based guidelines and psychometric analysis.
- The initial difficulty and impact of the revised tests were not assessed with students.
- Enhanced test item discrimination and quality correlated with lower student scores, indicating a need for further evaluation.
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