A many-facet Rasch measurement model approach to investigating objective structured clinical examination item parameter drift.

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Karen Coetzee, Sandra Monteiro, Luxshi Amirthalingam
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引用次数: 0

Abstract

Rationale: Objective Structured Clinical Examinations (OSCEs) are widely used for assessing clinical competence, especially in high-stakes environments such as medical licensure. However, the reuse of OSCE cases across multiple administrations raises concerns about parameter stability, known as item parameter drift (IPD). AIMS & OBJECTIVES: This study aims to investigate IPD in reused OSCE cases while accounting for examiner scoring effects using a Many-facet Rasch Measurement (MFRM) model.

Method: Data from 12 OSCE cases, reused over seven administrations of the Internationally Educated Nurse Competency Assessment Program (IENCAP), were analyzed using the MFRM model. Each case was treated as an item, and examiner scoring effects were accounted for in the analysis.

Results: The results indicated that despite accounting for examiner effects, all cases exhibited some level of IPD, with an average absolute IPD of 0.21 logits. Three cases showed positive directional trends. IPD significantly affected score decisions in 1.19% of estimates, at an invariance violation of 0.58 logits.

Conclusion: These findings suggest that while OSCE cases demonstrate sufficient stability for reuse, continuous monitoring is essential to ensure the accuracy of score interpretations and decisions. The study provides an objective threshold for detecting concerning levels of IPD and underscores the importance of addressing examiner scoring effects in OSCE assessments. The MFRM model offers a robust framework for tracking and mitigating IPD, contributing to the validity and reliability of OSCEs in evaluating clinical competence.

研究客观结构化临床检查项目参数漂移的多面 Rasch 测量模型方法。
理论依据:客观结构化临床考试(OSCE)被广泛用于评估临床能力,尤其是在医学执照等高风险环境中。然而,在多次考试中重复使用 OSCE 病例会引发对参数稳定性的担忧,即所谓的项目参数漂移(IPD)。目的与目标:本研究旨在调查重复使用的 OSCE 案例中的 IPD,同时使用多面 Rasch 测量(MFRM)模型考虑考官的评分效应:采用 MFRM 模型分析了国际教育护士能力评估项目(IENCAP)7 次考试中重复使用的 12 个 OSCE 案例数据。每个案例被视为一个项目,分析中考虑了考官评分的影响:结果表明,尽管考虑了考官的影响,但所有病例都表现出一定程度的 IPD,平均绝对 IPD 为 0.21 logits。三个案例呈现出正方向趋势。在 1.19% 的估分中,IPD 严重影响了分数的决定,违反了 0.58 logits 的不变性:这些研究结果表明,虽然 OSCE 案例在重复使用方面表现出足够的稳定性,但持续监测对于确保分数解释和决定的准确性至关重要。这项研究为检测IPD的相关水平提供了一个客观阈值,并强调了在OSCE评估中解决考官评分效应的重要性。MFRM 模型为跟踪和减轻 IPD 提供了一个强大的框架,有助于提高 OSCE 评估临床能力的有效性和可靠性。
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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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