Context and setting Medical educators frequently use a completely arbitrary method for determining passing scores on local medical school examinations, for example '70% is passing' for all examinations. This arbitrary approach has three serious flaws: it does not consider the difficulty of the test items; it is not systematic; and it does not allow content experts to make reasonable judgements about student competence. Our proposed standard setting method addresses all three of these concerns. Why the idea was necessary A completely arbitrary method of standard setting, deeply rooted in tradition and expedience, threatens the meaningful interpretation of test scores. We sought a more defensible method of standard setting that would not impose unacceptable demands on staff time.
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