Postgraduate Clinical Residency: The Impact of Multiple-Choice Question Quality on Exam Success Rates.

IF 1.7 Q2 EDUCATION, SCIENTIFIC DISCIPLINES
Advances in Medical Education and Practice Pub Date : 2025-08-06 eCollection Date: 2025-01-01 DOI:10.2147/AMEP.S525828
Omer Eladil Abdalla Hamid Mohammed, Suresh Kumar Srinivasamurthy, Raghavendra Bhat, Yasir Ahmed Mohamed Alhassan Eltahir, Hesham Amin Hamdy Elshamly, Fatima Mohammed, Bashir Hamad
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引用次数: 0

Abstract

Objective: To examine the impact of quality parameters in the construction of multiple-choice questions (MCQs) and their associated psychometric analysis for a selected Specialty X (SpX) in the Qualifying Residency Entry Exam (QRE) at a Postgraduate Medical Institute.

Methods: A post-validation cross-sectional analytical study was conducted using a non-probability purposive judgmental sampling technique. The SpX was chosen from one clinical specialities with the lowest exam success rates among the 52 specialities in the 2020-2023 QRE cycles. MCQs were evaluated using standard item analysis parameters: questions were considered acceptable range if they had a difficulty index (DIF) between 0.30-0.70, a discrimination index ≥0.2, and at least two functioning distractors.

Results: Out of 175 candidates who appeared for the QRE, only 19 (10.86%) passed. The exam included 120 A-type MCQs, with just 7 (5.8%) flaw-free Items/Questions. Most questions (98.3%) lacked clinical vignettes, and only 10% used the proper lead-in format. Two-thirds failed the "cover-the-options" test, and 40% showed constructional flaws related to testwiseness or irrelevant difficulty. Psychometric analysis showed a mean difficulty index of 45.9, with 86.7% of Items/Questions in the acceptable range. However, 15% had extremely poor discrimination (mean PBS = 0.17), and the mean distractor efficiency was 66%. A statistically significant relationship (p < 0.05) was observed between constructional flaws and DIF, DisI/PBS, the Horst Index, and Bloom's levels. Furthermore, no significant relationship was identified between the exam success rate and the type of MBBS curriculum.

Conclusion: The quality of Items/Questions in the postgraduate residency significantly impacted the QRE. Other potentially influential factors require further multivariate analytical research. This highlights the need for strategic educational initiatives to enhance Exam Bank development, strengthen capacity building, and improve faculty assessment skills.

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研究生临床住院医师:选择题质量对考试成功率的影响。
目的:探讨质量参数对某医学研究生院住院医师资格考试(QRE)某专业(SpX)多项选择题(mcq)构建及其相关心理测量分析的影响。方法:采用非概率目的性判断抽样技术进行验证后横断面分析研究。SpX是从2020-2023年QRE周期的52个专业中考试成功率最低的一个临床专业中选出的。mcq使用标准项目分析参数进行评估:如果问题的难度指数(DIF)在0.30-0.70之间,辨别指数≥0.2,并且至少有两个功能性干扰因素,则认为问题是可接受的范围。结果:参加QRE考试的175名考生中,只有19人(10.86%)通过。考试包括120个a型mcq,只有7个(5.8%)没有缺陷。大多数问题(98.3%)缺乏临床小插曲,只有10%的问题使用了适当的导入格式。三分之二的人未能通过“涵盖选项”测试,40%的人表现出与测试性或无关困难相关的结构缺陷。心理测量分析显示,平均难度指数为45.9,86.7%的项目/问题在可接受范围内。但是,15%的人鉴别极差(平均PBS = 0.17),平均牵引器效率为66%。构建缺陷与DIF、DisI/PBS、Horst指数、Bloom’s水平有统计学意义(p < 0.05)。此外,考试成功率与MBBS课程类型之间没有显著关系。结论:研究生住院医师项目/问题的质量对QRE有显著影响。其他潜在的影响因素需要进一步的多变量分析研究。这突出表明需要采取战略性教育举措,以加强考试库的发展,加强能力建设,提高教师的评估技能。
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来源期刊
Advances in Medical Education and Practice
Advances in Medical Education and Practice EDUCATION, SCIENTIFIC DISCIPLINES-
CiteScore
3.10
自引率
10.00%
发文量
189
审稿时长
16 weeks
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