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The question mark option in traditional medical progress tests (PT) can bias results. Computer adaptive-PT (CA-PT) shows that students using the question mark option performed better, indicating formula scoring captures more than just knowledge.

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Area of Science:

  • Medical Education
  • Assessment and Evaluation
  • Psychometrics

Background:

  • Traditional formula scoring in medical progress tests (PT) uses a question mark option to deter guessing.
  • This feature may disadvantage risk-averse students and introduce bias due to test-taking strategies.
  • Dutch medical schools transitioned to computer adaptive-PT (CA-PT) using Item Response Theory, dynamically adjusting difficulty and omitting the question mark option.

Purpose of the Study:

  • To evaluate the impact of the question mark option in conventional PT on subsequent performance in CA-PT.
  • To explore the relationship between question mark usage in traditional PT and student ability assessment via CA-PT.
  • To analyze variability in the effect of question mark usage across different student cohorts.

Main Methods:

  • Retrospective analysis of data from medical students across seven faculties who completed both conventional PT and CA-PT.
  • Assessment of Z-scores for total and question mark scores (unanswered questions) in conventional PT, and theta scores in CA-PT.
  • Linear modeling to determine the effect of question mark score on theta, controlling for conventional PT score; cluster analysis for student subgroups.

Main Results:

  • Students with similar conventional PT scores who utilized the question mark option (left more questions unanswered) generally showed better performance on CA-PT.
  • This effect was observed to diminish as students progressed through their academic studies.
  • Cluster analysis indicated variable effects across student subgroups, most prominent in year 4, with a reversed effect noted in year 5.

Conclusions:

  • The use of the question mark option in formula scoring significantly influences student performance, demonstrating considerable variability.
  • This variability suggests that formula scoring assesses factors beyond pure knowledge, such as test-taking strategies or risk aversion.
  • Aligning assessment scoring methods with their intended educational goals is crucial for accurate ability measurement.