Taylor, Celia A., Gurnell, Mark, Melville, Colin R., Kluth, David C., Johnson, Neil and Wass, Val (2017) Variation in passing standards for graduation-level knowledge items at UK medical schools. Medical Education, 51 (6). pp. 612-620. doi:10.1111/medu.13240 ISSN 0308-0110.

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Abstract

Objectives: Given the absence of a common passing standard for students at UK medical schools, this paper compares independently set standards for common ‘one from five’ single-best-answer (multiple-choice) items used in graduation-level applied knowledge examinations and explores potential reasons for any differences.

Methods: A repeated cross-sectional study was conducted. Participating schools were sent a common set of graduation-level items (55 in 2013–2014; 60 in 2014–2015). Items were selected against a blueprint and subjected to a quality review process. Each school employed its own standard-setting process for the common items. The primary outcome was the passing standard for the common items by each medical school set using the Angoff or Ebel methods.

Results: Of 31 invited medical schools, 22 participated in 2013–2014 (71%) and 30 (97%) in 2014–2015. Schools used a mean of 49 and 53 common items in 2013–2014 and 2014–2015, respectively, representing around one-third of the items in the examinations in which they were embedded. Data from 19 (61%) and 26 (84%) schools, respectively, met the inclusion criteria for comparison of standards. There were statistically significant differences in the passing standards set by schools in both years (effect sizes (f2): 0.041 in 2013–2014 and 0.218 in 2014–2015; both p < 0.001). The interquartile range of standards was 5.7 percentage points in 2013–2014 and 6.5 percentage points in 2014–2015. There was a positive correlation between the relative standards set by schools in the 2 years (Pearson's r = 0.57, n = 18, p = 0.014). Time allowed per item, method of standard setting and timing of examination in the curriculum did not have a statistically significant impact on standards.

Conclusions: Independently set standards for common single-best-answer items used in graduation-level examinations vary across UK medical schools. Further work to examine standard-setting processes in more detail is needed to help explain this variability and develop methods to reduce it.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Medical colleges -- Great Britain, Multiple-choice examinations, Medicine -- Examinations
Journal or Publication Title:	Medical Education
Publisher:	Blackwells
ISSN:	0308-0110
Official Date:	June 2017
Dates:	Date Event June 2017 Published 13 March 2017 Available 18 October 2016 Accepted 21 June 2016 Submitted
Volume:	51
Number:	6
Page Range:	pp. 612-620
DOI:	10.1111/medu.13240
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Date of first compliant deposit:	16 March 2017
Date of first compliant Open Access:	13 March 2018
Funder:	Medical Schools Council (Great Britain)

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