Using Process Data to Evaluate the Impact of Shortening Allotted Case Time in a Simulation-Based Assessment

The Computer-based Case Simulations (CCS) component of the United States Medical Licensing Examination (USMLE) Step 3 was developed to assess the decision-making and patient-management skills of physicians. Process data can provide deep insights into examinees’ behavioral processes related to completing the CCS assessment task. In this paper, we utilized process data to evaluate the impact of shortening allotted time limit by rescoring the CCS cases based on process data extracted at various timestamps that represented different percentages of the original allotted case time. It was found that examinees’ performance as well as the correlation between original and newly generated scores both tended to decrease as the timestamp condition became stricter. The impact of shortening allotted time limit was found marginally associated with case difficulties, but strongly dependent on the case time intensity under the original time setting.