Comparison of Psychometric Performance of Faculty and Student Authored Anatomy Exam Items in Medical Education

Near-peer teaching is an effective method for improving student retention and comprehension in undergraduate medical education. This approach involves students providing content instruction to peers who are one or more years junior. Both the student-teacher and the recipient have been found to benefit from increased self-confidence and understanding of the material in pre-clinical and clinical environments. At the University of South Carolina School of Medicine Greenville (USCSOMG), we implemented an elective rotation for fourth-year medical students (M4s) that included teaching anatomy to first-year students in the dissection lab and writing summative exam questions with faculty review similar to the process faculty undergo. M4s contributed to organ system-centric exams during the 2021-2022 and 2022-2023 academic years. Test items were analyzed to assess their difficulty, discrimination index, and point biserial, comparing questions written by faculty and M4s. A significant difference was found in point biserials of exams 2 C and 2D, (Exam 2 C: Faculty 0.1467, M4 0.2342, P < 0.001; Exam 2D: Faculty 0.33, M4 0.1829, P = 0.007) and discrimination index of exam 2 C (Exam 2 C: Faculty 0.8525, M4 0.8850, P = 0.031). These results highlight the unique strengths both groups bring to the question-writing process: faculty's advanced content knowledge and experience, and M4s' recent familiarity with the material. Based on these findings, we propose leveraging upper-class medical students as valuable resources in generating assessment materials. This practice can contribute to a more clinically-relevant curriculum and enhance the educational skills of early-career doctors.