Assessment Question Characteristics Predict Medical Student Performance in General Pathology

Area of Science:

• Medical Education
• Pathology Assessment

Background:

• Medical curricula evaluation necessitates appraising student assessments for deeper learning.
• General pathology is a foundational first-year medical course covering core disease concepts.

Purpose of the Study:

• To compare assessment question types and identify predictors of student scores, difficulty, and discrimination.
• To optimize medical education assessment strategies.

Main Methods:

• Item-level analysis of 125 questions from quizzes and a final exam over 3 years (417 students).
• Categorization by question type, clinical vignette presence, specimen image, information depth, knowledge density, and Bloom taxonomy level.
• Multivariate analysis to determine significant predictors of performance, difficulty, and discrimination.

Main Results:

• Multiple choice questions were linked to lower scores (P=.004), higher difficulty (P=.02), and poorer discrimination (P=.002).
• Specimen images correlated with better discrimination (P=.04).
• Interpretation-based questions showed lower scores (P=.003) and higher difficulty (P=.046) compared to recall.

Conclusions:

• Medical education assessments should integrate diverse question characteristics.
• A combination of question types is crucial for enhancing student performance, optimizing difficulty, and achieving effective item discrimination.