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Evaluating an Iteratively Revised Assessment for a Global Pediatric Surgery Short Course Using Mixed-Effects Modeling
Erin Kim1, Phillip J Hsu2, Deborah M Rooney3
1Department of Surgery, Brigham and Women's Hospital, Boston, MA.
Journal of Surgical Education
|July 25, 2026
Summary
A one-day pediatric surgery course significantly improved physician knowledge, with assessment revisions maintaining score consistency. Language preference showed a slight impact on total scores and management domain performance.
Area of Science:
- Global Health Education
- Medical Education Research
- Surgical Training
Background:
- Nonspecialist physicians in low-resource settings require enhanced pediatric surgery skills.
- Short-course training is a potential strategy to improve surgical knowledge.
- Standardized and reliable assessments are crucial for evaluating training effectiveness.
Purpose of the Study:
- To assess the impact of a global pediatric surgery short course on physician performance.
- To evaluate the consistency of assessment scores across multiple revised versions.
- To identify item-level performance and potential language bias in the assessment.
Main Methods:
- Prospective pre- and post-course assessment design.
- Generalized linear mixed-effects models for overall and domain-level score analysis.
- Many-facet Rasch modeling for item-level analysis and language bias detection.
Main Results:
- Significant improvement in overall scores (71.3% to 86.5%) and all domains (Diagnosis, Transfer, Management).
- No significant differences in scores or score changes across 4 assessment versions.
- Language preference was associated with total scores and the Management domain; French-preferring learners showed some disadvantage.
Conclusions:
- A single-day pediatric surgery course effectively enhances physician knowledge.
- Iterative assessment revisions ensure score comparability and reliability.
- Language preference should be considered in assessments for diverse learner populations.