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Biomedical subjects

Ronald K Hambleton

Publications and source records attributed to Ronald K Hambleton.

7 recordsLinked to original sources
PubMed2006

Computer adaptive testing improved accuracy and precision of scores over random item selection in a physical functioning item bank.

BACKGROUND AND OBJECTIVE: Measuring physical functioning (PF) within and across postacute settings is critical for monitoring outcomes of rehabilitation; however, most current instruments lack sufficient breadth and feasibility for widespread use. Computer adaptive testing (CAT), in which item selection is tailored to the individual patient, holds promise for reducing response burden, yet maintaining measurement precision. We calibrated a PF item bank via item response theory (IRT), administered items with a post hoc CAT design, and determined whether CAT would improve accuracy and precision of score estimates over random item selection. METHODS: 1,041 adults were interviewed during postacute care rehabilitation episodes in either hospital or community settings. Responses for 124 PF items were calibrated using IRT methods to create a PF item bank. We examined the accuracy and precision of CAT-based scores compared to a random selection of items. RESULTS: CAT-based scores had higher correlations with the IRT-criterion scores, especially with short tests, and resulted in narrower confidence intervals than scores based on a random selection of items; gains, as expected, were especially large for low and high performing adults. CONCLUSION: The CAT design may have important precision and efficiency advantages for point-of-care functional assessment in rehabilitation practice settings.

Activities of Daily Living↗
PubMed2005

Scoring standardized patient examinations: lessons learned from the development and administration of the ECFMG Clinical Skills Assessment (CSA).

Throughout the 40 year history of standardized patient assessments and OSCEs, there have been numerous advancements, including many that involve scoring the simulated clinical encounters. While there is no clear agreement on how examinees' performance should be documented or scored in an encounter, there is a consensus that several well-chosen SP encounters are required to produce reliable examinee scores. There also continues to be some debate as to who should do the scoring on an SP-based assessment. While logistics and cost will certainly play a role, it is probably best to use the person who is most familiar with the domain being assessed. In some instances this will be the SP; in others, an outside observer or content expert. Finally, with the growing use of OSCEs for summative purposes (e.g. certification, licensure), special attention must be paid to fairness issues. Since the same test form cannot be used day after day, examinee scores must be 'equated', taking into account the psychometric properties of scores from individual cases and individual SPs. To date, the CSA has been one of the highest-volume, high-stakes, standardized patient assessments to be developed and successfully administered. In 2003 alone, over 11 500 IMGs were tested. The early conceptual framework for this assessment was synthesized from the research endeavours of several notable individuals, including, amongst many others, Harden et al. 1975, Swanson & Stillman, 1990, Newble & Swanson, 1988, Vu et al. 1992 and Colliver, 1995. The early prototype administrations of the CSA, including many operational research studies, were supported and guided by Dr Friedman Ben-David, Friedman et al. 1991, 1993, Stillman et al. 1992, and Sutnick et al. 1993, 1995.

Clinical Competence↗
PubMed2005

A work-centered approach for setting passing scores on performance-based assessments.

Standardized patient examinations are being used for high-stakes decisions (e.g., graduation, licensure, and certification) with growing frequency. Concurrently, research on methods to determine the passing score for these types of performance-based assessments has increased. A wide variety of approaches have been considered in the past several years, many based on traditional techniques developed for use with multiple-choice examinations. More and more, techniques that center on review of examinee work have been employed, often resulting in the establishment of defensible, reproducible standards. The purpose of this article is to describe and evaluate a work-centered approach for determining the passing score for a performance-based assessment of clinical skills. A description of an approach to set passing scores that involves expert review of examinee work is presented. Application and evaluation of the method are illustrated using examination materials obtained from a high-stakes certification assessment.

Certification↗
PubMed2003

Quality assurance methods for performance-based assessments.

Performance assessments are subject to many potential error sources. For performance-based assessments, including standardized patient (SP) examinations, these error sources, if left unchecked, can compromise the validity and reliability of scores. Quality assurance (QA) measures, both quantitative and qualitative, can be used to ensure that candidate scores are accurate and reasonably free from measurement error. The purpose of this paper is to outline several QA strategies that can be used to identify potential content- and score-related problems with SP assessments. These approaches include case analyses and various comparisons of primary and observer scores. Specific examples from the ECFMG Clinical Skills Assessment (CSA) are used to educate the reader concerning appropriate statistical methods and legitimate data interpretations. The results presented in this investigation highlight the need for well-defined training regimes, regular feedback to those involved in rating/scoring performances, and detailed statistical analyses of all scores.

Clinical Competence↗
PubMed2003

The effect of task exposure on repeat candidate scores in a high-stakes standardized patient assessment.

BACKGROUND: Failing candidates often make multiple attempts on licensure and certification examinations. For performance-based assessments, where available test material is often limited, overlap in examination content is frequently inevitable. PURPOSE: The purpose of this study was to investigate the performance of repeat candidates, both on new and exposed material, on a standardized patient clinical skills assessment. METHODS: Analysis of variance techniques were used to investigate the longitudinal performance of repeat candidates. Score differences for the second test session were analyzed as function of prior exposure to assessment materials. RESULTS: Although the performance of candidates improved between the first and second assessment, score increases could not be attributed to the random exposure of examination material. CONCLUSIONS: The exposure of case content on clinical skills examinations does not appear to provide any advantage, or disadvantage, to repeat test takers. This finding, although based on average scores for repeat examinees, suggests that valid assessment scores can be obtained even if there is some overlap in assessment content.

Adult↗