Factors influencing reproducibility of tests using standardized patients
- 1 January 1989
- journal article
- research article
- Published by Informa UK Limited in Teaching and Learning in Medicine
- Vol. 1 (3), 158-166
- https://doi.org/10.1080/10401338909539401
Abstract
Psychometric studies of assessment with standardized patients (SPs) have established that substantial testing time is required to obtain reproducible scores. Using data drawn from two recent large‐scale studies, this article explores the reasons behind this result and suggests several strategies for reducing testing‐time requirements. Case‐specificity—inconsistency of an examinee's performance over cases—appears to be the major source of measurement error in SP‐based tests. Use of multiple SPs to play the same case role for different examinees does not affect reproducibility of scores at typical test lengths. Similarly, low‐to‐moderate levels of interrater agreement do not markedly affect score reproducibility, as long as a reasonably large number of cases are included in an assessment. Often, SP‐based assessment can be viewed within a mastery‐testing framework, where reproducibility of pass‐fail decisions, rather than scores, is of primary importance. Testing‐time requirements within a mastery‐testing framework depend, in part, on the quality of group performance in relation to the pass‐fail point: If performance is quite good (or quite poor), relatively short tests can be used without compromising reproducibility of pass‐fail decisions. Adoption of a sequential testing approach, in which a brief screening test is given initially to identify examinees close to the pass‐fail point, can further reduce use of testing resources. Alternatively, SP‐based assessment can be incorporated into batteries with written tests to reduce testing time without sacrificing beneficial educational effects.Keywords
This publication has 14 references indexed in Scilit:
- Factors influencing testing time requirements for measurements using written simulationsTeaching and Learning in Medicine, 1989
- Psychometric characteristics of the objective structured clinical examinationMedical Education, 1988
- A diagnostic fourth-year performance assessmentArchives of Internal Medicine, 1987
- An objective measure of clinical performanceAmerican Journal Of Medicine, 1987
- Knowledge and clinical problem-solvingMedical Education, 1985
- Simulation in health sciences educationJournal of Instructional Development, 1985
- The effect of assessments and examinations on the learning of medical studentsMedical Education, 1983
- A Variance Components Model for Measurement Procedures Associated with a Table of SpecificationsApplied Psychological Measurement, 1982
- The validity and reliability of a new examination of the clinical competence of medical studentsMedical Education, 1981
- Agreement Coefficients as Indices of Dependability for Domain-Referenced TestsApplied Psychological Measurement, 1980