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Minimum accepted competency examination: test item analysis.

Paddy McCrossan1, Alf Nicholson2, Naomi McCallion3

  • 1Academic Clinical Lecturer, Queen's University Belfast, 97 Lisburn Rd, Belfast, BT9 7BL, UK. p.mccrossan@qub.ac.uk.

BMC Medical Education
|May 25, 2022
PubMed
Summary
This summary is machine-generated.

The Minimum Accepted Competency (MAC) examination revealed significant knowledge gaps in undergraduate medical students regarding essential pediatric practice, despite their success on standard university exams. This highlights discrepancies between academic curricula and clinical expectations for junior doctors.

Keywords:
AssessmentCompetenceMedical educationMultiple choice questionsStandard setting

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Area of Science:

  • Medical Education
  • Pediatric Assessment
  • Psychometric Analysis

Background:

  • Undergraduate medical students' pediatric knowledge was assessed using a Minimum Accepted Competency (MAC) examination, designed by non-faculty clinicians to test essential knowledge.
  • A significant disparity was observed, with only two-thirds of students passing the MAC exam, contrasting sharply with the 96% pass rate on their official university pediatric examination.
  • This discrepancy prompted an investigation into the psychometric properties of the MAC examination and the reasons behind the differing student performance.

Purpose of the Study:

  • To describe the psychometric properties of the MAC examination.
  • To explore the reasons for performance differences between the MAC and university examinations.
  • To assess the reliability of the MAC examination as a tool for evaluating undergraduate pediatric knowledge.

Main Methods:

  • The MAC examination was administered to undergraduate medical students and pediatric trainee doctors.
  • Test item analysis was conducted using facility index, discrimination index, and Cronbach's alpha.
  • Item difficulty was correlated with established standards.

Main Results:

  • Item difficulty was positively correlated across groups and with established standards.
  • 18 out of 30 items had a discrimination index greater than 0.2.
  • Cronbach's alpha values ranged from 0.22 to 0.59, indicating variable reliability.

Conclusions:

  • The MAC examination identified significant areas where students performed poorly, suggesting a gap between academic knowledge and clinical practice requirements.
  • The findings highlight a potential divergence in expected knowledge levels between university faculty and practicing clinicians for junior doctors entering pediatrics.
  • The MAC examination is a feasible method for assessing basic medical knowledge, offering insights into curriculum deficiencies and the 'hidden curriculum' of clinical practice.