Development and validation of a multiple-choice questionnaire-based theoretical test in direct ophthalmoscopy
Morten Jørgensen1,2,3, Mona Meral Savran2,4, Christos Christakopoulos5
1Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark.
Acta Ophthalmologica
|March 1, 2019
Summary
A new multiple-choice questionnaire (MCQ) test effectively assesses theoretical knowledge for direct ophthalmoscopy. This validated tool aids in measuring and certifying physician competency in this crucial diagnostic skill.
Area of Science:
- Medical Education
- Ophthalmology
- Diagnostic Skills Assessment
Background:
- Direct ophthalmoscopy is vital for detecting systemic, neurologic, and ophthalmic conditions.
- Proficiency in direct ophthalmoscopy is often lacking among junior physicians.
- A standardized theoretical assessment is needed to evaluate educational interventions.
Purpose of the Study:
- To develop and validate a multiple-choice questionnaire (MCQ)-based theoretical test for direct ophthalmoscopy.
- To provide an evidence-based method for assessing theoretical knowledge in direct ophthalmoscopy.
Main Methods:
- Expert interviews and a Delphi-like process were used to develop MCQ content.
- Validity evidence was gathered using Messick's framework, including content, response process, internal structure, relations to other variables, and consequences.
- The test was administered to ophthalmologists and medical students to evaluate its discriminatory power and establish a pass-fail threshold.
Main Results:
- An initial pool of 100 MCQs was refined to 60 items meeting relevance and quality criteria.
- The test demonstrated high internal consistency (Cronbach's alpha = 0.95) and effectively differentiated between medical students and specialists (p < 0.001).
- A pass-fail score of 83% correct answers showed no false positives or negatives, with 15 items sufficient for certification.
Conclusions:
- An MCQ-based theoretical test for direct ophthalmoscopy has been developed and validated.
- This test provides a reliable and evidence-based method for measuring, evaluating, and certifying essential theoretical knowledge for direct ophthalmoscopy.
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