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

Area of Science:

• Medical Education
• Psychometrics
• Educational Assessment

Background:

• Standardized guidelines for creating equivalent pre- and post-tests in problem-solving are lacking.
• Ensuring test parallelism is crucial for accurate measurement of learning gains.
• Existing methods for multiple-choice tests may not directly apply to problem-solving assessments.

Purpose of the Study:

• To devise a method for constructing equivalent pre- and post-tests for problem-solving.
• To demonstrate the effectiveness of the devised method using patient management problems (PMPs).
• To provide a framework for creating isomorphic problems for assessment purposes.

Main Methods:

• Developed a method focusing on maintaining problem structure while altering superficial appearance (isomorphism).
• Applied the method to create 10 patient management problems (PMPs) and their isomorphic counterparts.
• Assessed the equivalence or parallelism between the original PMPs and their isomorphic versions.

Main Results:

• Demonstrated the equivalence or parallelism of 10 PMPs with their isomorphic counterparts.
• The method successfully created problems that appeared different to examinees but maintained structural similarity.
• The isomorphism approach proved effective in establishing test parallelism for PMPs.

Conclusions:

• The devised method for creating isomorphic problems is effective for developing equivalent pre- and post-tests.
• This approach is applicable beyond patient management problems to other types of problem-solving assessments.
• The findings offer a practical solution for creating reliable and valid problem-solving tests in the absence of specific guidelines.