Isomorphic patient management problems: a method of creating equivalent problem-solving tests

Multiple choice format pre- and post-tests have a high likelihood of being equivalent (i.e. parallel) if well-known guidelines are followed. In the absence of such guidelines for pre- and post-tests of problem-solving, the authors devised a simple method of creating problems that are likely to be equivalent. The method was employed with patient management problems (PMPs) and focuses on maintaining the same form or structure of the problems while making the problems appear different to the examinee. Such problems are 'isomorphic'. The equivalence or parallelism of 10 PMPs with their isomorphic counterparts was demonstrated. The method for creating isomorphic PMPs appears to be applicable for creating equivalent pre- and post-tests composed of problems other than PMPs.