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Type: Journal article
Title: The modified essay question: Its exit from the exit examination
Author: Palmer, E.
Duggan, P.
Devitt, P.
Russell, R.
Citation: Medical Teacher, 2010; 32(7):E300-E307
Publisher: Carfax Publishing
Issue Date: 2010
ISSN: 0142-159X
Statement of
Edward J. Palmer, Paul Duggan, Peter G. Devitt and Rohan Russell
Abstract: Background: Exit examinations in medicine are ‘high stakes’ examinations and as such must satisfy a number of criteria including psychometric robustness, fairness and reliability in the face of legal or other challenges. Aims: We have undertaken a critical review of the exit examination from the University of Adelaide focussing on the written components. This examination consisted of an objective structure clinical examination (OSCE), a multiple choice question (MCQ) paper and a modified essay question (MEQ) paper. Methods: The two written papers were assessed for item writing flaws and taxonomic level using modified Bloom's criteria. Curriculum experts independently assessed adequacy of the examination for validity and fidelity. Results: The overall examination had good fidelity and validity. The results of the MEQ and MCQ were strongly and positively correlated and there was a weak negative correlation between these papers and the OSCE. The MEQ had a higher proportion of questions focussed on recall of knowledge and the questions were more structurally flawed compared with the MCQs. The MEQ re-marking process resulted in lower scores than were awarded by the original, discipline-based expert markers. The MEQ paper failed to achieve its primary purpose of assessing higher cognitive skills. Conclusion: The University of Adelaide's MBBS programme has since dropped the MEQ paper from its exit examination and is evaluating in its place the Script Concordance test.
Keywords: Humans; Reproducibility of Results; Psychometrics; Education, Medical, Undergraduate; Educational Measurement; Students, Medical; South Australia
Rights: Copyright © 2010 Informa Plc. All rights reserved.
RMID: 0020100607
DOI: 10.3109/0142159X.2010.488705
Appears in Collections:Medicine publications

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