期刊名称：Journal of Educational Evaluation for Health Professions
电子版ISSN：1975-5937
出版年度：2017
卷号：14
期号：1
页码：1-6
DOI：10.3352/jeehp.2017.14.19
语种：English
出版社：Korea Health Insurance Licensing Examination Institute
摘要：Purpose:In a sequential objective structured clinical examination (OSCE),all students initially take a short screening OSCE.Exam_x0002_inees who pass are excused from further testing,but an additional OSCE is administered to the remaining examinees.Previous inves?tigations of sequential OSCE were based on classical test theory.We aimed to design and evaluate screening OSCEs based on item re?sponse theory (IRT).Methods:We carried out a retrospective observational study.At each station of a 10-station OSCE,the students’ performance was graded on a Likert-type scale.Since the data were polytomous,the difficulty parameters,discrimination parameters,and students’ ability were calculated using a graded response model.To design several screening OSCEs,we identified the 5 most dif?ficult stations and the 5 most discriminative ones.For each test,5,4,or 3 stations were selected.Normal and stringent cut-scores were defined for each test.We compared the results of each of the 12 screening OSCEs to the main OSCE and calculated the positive and negative predictive values (PPV and NPV),as well as the exam cost.Results:A total of 253 students (95.1%) passed the main OSCE,while 72.6% to 94.4% of examinees passed the screening tests.The PPV values ranged from 0.98 to 1.00,and the NPV values ranged from 0.18 to 0.59.Two tests effectively predicted the results of the main exam,resulting in financial savings of 34% to 40%.Conclu?sion:If stations with the highest IRT-based discrimination values and stringent cut-scores are utilized in the screening test,sequential OSCE can be an efficient and convenient way to conduct an OSCE.
关键词：Purpose:In a sequential objective structured clinical examination (OSCE),all students initially take a short screening OSCE.Exam_x0002_inees who pass are excused from further testing,but an additional OSCE is administered to the remaining examinees.Previous inves?tigations of sequential OSCE were based on classical test theory.We aimed to design and evaluate screening OSCEs based on item re?sponse theory (IRT).Methods:We carried out a retrospective observational study.At each station of a 10-station OSCE,the students’ performance was graded on a Likert-type scale.Since the data were polytomous,the difficulty parameters,discrimination parameters,and students’ ability were calculated using a graded response model.To design several screening OSCEs,we identified the 5 most dif?ficult stations and the 5 most discriminative ones.For each test,5,4,or 3 stations were selected.Normal and stringent cut-scores were defined for each test.We compared the results of each of the 12 screening OSCEs to the main OSCE and calculated the positive and negative predictive values (PPV and NPV),as well as the exam cost.Results:A total of 253 students (95.1%) passed the main OSCE,while 72.6% to 94.4% of examinees passed the screening tests.The PPV values ranged from 0.98 to 1.00,and the NPV values ranged from 0.18 to 0.59.Two tests effectively predicted the results of the main exam,resulting in financial savings of 34% to 40%.Conclu?sion:If stations with the highest IRT-based discrimination values and stringent cut-scores are utilized in the screening test,sequential OSCE can be an efficient and convenient way to conduct an OSCE.
