borderline regression
در نشریات گروه پزشکی-
Background & Objective
Objective Structured Clinical Examination (OSCE) is a crucial component in medical school examinations to assess students’ competency, particularly in clinical skills incorporating cognitive and affective domains. OSCE results are subjected to standard-setting methods, which yield different findings. Hence, in this study, five different standard-setting methods, namely norm reference, Angoff method, borderline group method (BGM), borderline regression method (BRM), and modified Cohen’s method, were compared to determine the cut-off scores and failure rates determined by each method.
Material & MethodsData of 170 second-year medical students who attended OSCE with eight stations for their First Professional Examination at the end of year 2 MBBS was taken for the study following ethical approval. Total scores for each station were standardized to 20 marks, and cut-off scores were determined using each of the five standard-setting methods.
ResultsAs a comparison of 5 methods, the Norm reference method yielded the highest number of stations with high cut-off scores, followed by BRM. This is reflected in the number of failures, too. On the contrary, using the Angoff method yielded the lowest cut-off scores in maximum stations, resulting in the least number of failed students. The Cochrane’s Q test of the results yielded a p < 0.001, which signifies that the proportion of students who failed a particular OSCE station was significantly different when different methods were used to determine the cut score.
ConclusionThe study, which compared 5 common standard-setting methods employed in medical education assessments, found that norm-referenced and BRM had high cut-off scores and failures, with the opposite determined by the Modified Angoff method. The study concluded that the cut-off score and failure rate differed with different standard-setting methods, and the choice of the method is contextual depending on the available resources.
Keywords: Standard Setting, OSCE, Angoff, Norm-Reference, Borderline Group, Borderline Regression, Cohen -
Background
One of the essential considerations while designing an OSCE exam is “standard-setting”, which refers to the score with which a student could be considered to pass or fail an exam. The selection of proper standard-setting method is based on different criteria, including the applicability of the method, the university bylaws, and the purpose of the test.
ObjectivesTo examine the difference between four different standard-setting
methodsthe modified Cohen’s, borderline regression, Hofstee methods, and the fixed 60% arbitrary method in determining the passing score in ophthalmology OSCE exam.
MethodsTwo periodic ophthalmology OSCE were selected to examine the differences in failure rates and pass scores. The four standard setting methods were applied with a sample size that included 38 (year 5 undergraduate) students at the Faculty of Medicine, Suez Canal University.
ResultsModified Cohen’s method resulted in the lowest passing score (54% and 58%), while the Hofstee method led to the highest passing score (69.2% and 75%). Comparing the percentage of students who are supposed to pass the exam, we can observe that there is no statistically significant difference among these standard-setting methods were used except for the Hofstee method.
ConclusionsThere is no single best method for setting the passing mark of an exam. We could obtain more practical outcomes if we considered more than one method and the average pass mark.
Keywords: OSCE, Standard Setting, Modified Cohen, Borderline Regression, Hofstee
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