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Recent advances of medical journals in Korea and and further development strategies: Is it possible for them to publish Nobel Prize-winning research? Sun Huh Journal of the Korean Medical Association.2018; 61(9): 524. CrossRef
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Application of computerized adaptive testing (CAT) in medical education is still spare in the high stakes examination or in the school-based examination. In the medical school in Belgium, CAT was used for an assessment tool in general practice as pilot test was reported. In Hallym University, CAT has been introduced in the evaluation of the students' performance as in-course general evaluation test and parasitology test. Another examples of application of CAT for high stakes examination are Medical Council of Canada Qualifying Examination - Part 1 in Canada and National Council Licensure EXamination - Registered Nurse in USA. CAT has some merits such as accurate estimation of the ability parameters of the examinees and the shorter period of examination. To apply the CAT in medical education more actively, medical teachers should have an interest in the modern measurement theories such as item response theory and technologies. It is still uncertain if CAT may be prosperous in the medical education as a tool for the measurement of the examinees' ability. However, we should prepare the era of application of CAT in high stakes examination such as medical licensing examination.
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PURPOSE In order to apply the item response theory to test results, the assumptions made about unidimensionality and item goodness-of-fitness should be tested before analysis.
To know if the Korean Medical Licensing Examination results fulfill these assumptions, appropriate tests were done on these two features.
METHODS Three results(from three subjects) of the Korean Medical Licensing Examination, done in January 2004, were converted into 1, 0 data. The Holland and Rosenbaum Method(HRMH) and DETECT were used to test unidimensionality.
The Winsteps was used to test goodness-of-fitness according to the Rasch model.
RESULTS Unidimensionality was rejected by HRMH but accepted by DETECT. With the Rasch model, 2 out of 550 items were inadequate. Each 137, 73 and 455 examinees out of 3,881 were inadequate in three subjects of 126, 400 and 24 items.
CONCLUSION The above results suggest that DETECT is desirable for testing unidimensionality of high-stakes tests with more than 100 items. According to the Rasch model, the Korean Medical Licensing Examination fulfills the goodness-of-fitness to be analyzed according to the item response theory.
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PURPOSE To determine possible differences in the ability of students from two consecutive medical school class years, test equating based on item response theory was performed on the results of a lecture examination. METHODS: The dataset for this study of the results of a medical school lecture exam was composed of the number of items and examinees: 75 students tested on 60 items in 2002, and 82 students tested on 50 items in 2003. We used common item non-equivalent group design and tested the assumption of unidimensionality and data-fitness. Item parameter estimates were based on the Rasch model, and the scale transformation was performed using mean/sigma moment methods. Equating was applied to both true and observed scores, and the results were analyzed. RESULTS: The slope and intercept for the scale transformation of the 2003 exam to the 2002 exam were 1.2796 and 0.9630, respectively. The mean and standard deviation of the ability parameter of the students taking the 2003 exam were 1.69 and 0.66, respectively. After scale transformation, the mean increased to 3.13 and the standard deviation increased to 0.85. For the 2002 exam, the mean was 0.70 and the standard deviation was 0.66. The correlation coefficient between the true and observed scores was 0.9994 (P=0.00). CONCLUSION: The difference in the ability parameter of students between the two years increased after scale transformation. Both the true and observed scores could be used interchangeably after equating. Thus, test equating based on item response theory may be applicable to medical school lecture examinations.
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Item Analysis of Clinical Performance Examination Using Item Response Theory and Classical Test Theory Hyun-Sun Lim, Young-Mee Lee, Duck-Sun Ahn, Joon-Young Lee, Hyung Im Korean Journal of Medical Education.2007; 19(3): 185. CrossRef
PURPOSE In 2002, extended-matching type (R-type) items were introduced to the Korean Medical Licensing Examination. To evaluate the usability of R-type items, the results of the Korean Medical Licensing Examination in 2002 and 2003 were analyzed based on item types and knowledge levels. METHODS: Item parameters, such as difficulty and discrimination indexes, were calculated using the classical test theory.
The item parameters were compared across three item types and three knowledge levels. RESULTS: The values of R-type item parameters were higher than those of A- or K-type items. There was no significant difference in item parameters according to knowledge level, including recall, interpretation, and problem solving. The reliability of R-type items exceeded 0.99. With the R-type, an increasing number in correct answers was associated with a decreasing difficulty index. CONCLUSION: The introduction of R-type items is favorable from the perspective of item parameters.
However, an increase in the number of correct answers in pick 'n'-type questions results in the items being more difficult to solve.
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Reforms of the Korean Medical Licensing Examination regarding item development and performance evaluation Mi Kyoung Yim Journal of Educational Evaluation for Health Professions.2015; 12: 6. CrossRef
PURPOSE & METHODS: Papers in six kinds of medical journals from Korea were examined on statistical methods to know what kinds of statistical methods had been used. We also tried to know how much Korean statistical program, dBSTAT can cover those statistical methods.
RESULTS Out of 841 papers, statistical methods were used in 415(49.4%) ones. Cumulative number of statistical methods is 869. According to the category of statistical methods, they were classified as following: Distribution analysis 6(0.7%), comparative statistics 577(66.4%), correlation analysis 66(7.6%), regression analysis 106(12.2%), classification analysis 3(0.3%), survival analysis 48(5.5%), genetic analysis 10(1.2%), and etc 53(6.5%).
CONCLUSION From above result, it can be said that dBSTAT can cover 92.7% of whole statistical methods in this study.
These results also can be used for the goal of curriculum of medical statistics for undergraduate, graduate course and resident training program.
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Correlations between the scores of computerized adaptive testing, paper and pencil tests, and the Korean Medical Licensing Examination Mee Young Kim, Yoon Hwan Lee, Sun Huh Journal of Educational Evaluation for Health Professions.2005; 2(1): 113. CrossRef
Students' Attitude toward and Acceptability of Computerized Adaptive Testing in Medical School and their Effect on the Examinees' Ability Mee Young Kim, Sun Huh Journal of Educational Evaluation for Health Professions.2005; 2(1): 105. CrossRef
After item analysis of examinations in College of Medicine, the correlation among characteristics were examined for the better understanding of their meaning. The 78 subjected examinations in College of Medicine, Hallym University, Korea from March 1999 to October 2000 were analyzed.
Discrimination indexes (D) by the method of extreme group were positively correlated with item-total correlation(ITC) with mean correlation coefficient r=0.8506 ranged between 0.6430 and 0.9520. Number of items of each examination was positively correlated with Cronbach coefficient alpha reliability index(r=0.7920) whereas negatively correlated with standard deviation(r=-0.5691), odd-even split reliability index(r=-0.8767) and mean ITC(r=-0.4079).
Thereafter, the standard deviation was positively correlated with odd-even split reliability index (r=0.5072) and mean ITC(r=0.6166). There was negative correlation between Cronbach coefficient alpha reliability index and odd-even split reliability index(r=-0.7385). Above results suggested that the number of items in each examination was most powerful factor affecting to other item analysis characteristics. The appropriate number of items should be considered for better result of item analysis characteristics. Odd-even split reliability index is not appropriate for the estimation of the reliability among item, since it decreased according to the increase of number of items. Positive and high correlation between D and ITC means that both methods are appropriate to interpretate the discriminating power of the items.
If medical campus is composed of multi-campus, the standardization of the students' clinical clerkship is one of the major concerns in medical education, since it is very difficult to supervise the precise students' performances by the executive officers. To improve and to standardize the clinical clerkship, the objective structured clinical examination and the clinical skill test was done and its results were analyzed. On February 11, 2001, the 85 junior students of the College of Medicine, Hallym University, undertook the examinations with 10 items. Mean of the results was 72.73. There was no significant difference of scores according to sex, and group of examinees. There was significant difference according to the hospital of students' clerkship in spite of there was no significant difference of the scores of written examination and total score of clinical clerkship. There was a significant difference of experiences of clinical skills according to the hospital. There was a positive correlation between degree of experience of clinical skills and scores (r=0.3888). The most important factor influencing the scores is believed to be a experience of clinical skills in the hospital since it can be postulated that the students' ability was not different according to the hospital. Also the depth of the clinical skill was also may be another influencing factor to the scores. When students works in multi-campus hospitals, the professors or educational supervisors should check the clinical skills as the guideline indicated, for the standardization of the clinical clerkship.
After opening of the item of examinations and correct answer, the objection on the answer or item itself was received through internet board from students in medical school. The behavioral change of students and professors was evaluated after this system. A total of 81 examinations was subjected in second semester of year 1999 and in year 2000 in Hallym University, Korea. Out of 5,478 items, 182 became targets of objection(3.4%). Of 182 items, 83 ones were revised according to the students opinion(45.6%). Although the rate of objection increased from 2.4% in 1999 to 4.0% in 2000, the rate of revision decreased from 59.3% in 1999 to 39.8% in 2000. Total revision rate was not significantly different between year 1999, 1.4 % and year 2000, 1.6 % (p=0.7080). This kind of opening of items and answers gave students a chance to discuss on items once again and to learn contents by feedback. Most of students want to maintain this kind of system after examination. It also made professors develop better and more lucid items. This is one of good examples of using internet in the evaluation of medical education.
This is made for teachers of medical schools not only to mark examination papers but also to do an item analysis easily. Functions of the program are marking examination result in text file, input of the result of descriptive examination, providing the result of item analysis according to the classical test theory(mean, standard deviation, reliability coefficient, answer response distribution, difficulty index, discriminating index, estimated number of examinee who select wrong answer), adding, saving and printing the results, providing, saving and printing record sheet, adding the results of equal or more than two separate examinations, sorting the record sheet by examinee's identification number and by record, input windows for item, and automatic inclusion of the result of item analysis in the item window. Much number of teachers of the medical schools may be encouraged to use this program to promote the quality of the evaluation.
Is it necessary to open the course "general chemistry" to help freshperson to complete courses of organic chemistry and physical chemistry in the preliminary course of College of Medicine, Hallym University? As a basic step to answer this question, the records of the organic chemistry and physical chemistry were compared according to "chemistry" selection at the College Scholastic Ability Test in the freshperson of College of Medicine, Hallym University in the year 2000. There was a significant difference of the records of organic chemistry between chemistry selecting group and chemistry non-selecting group that selected physics, biology and earth science. There was a no significant difference between chemistry selecting female and non-selecting female, although there was a significant difference between chemistry selecting male and non-selecting female. As for physical chemistry, the records of selecting chemistry group were higher than those of the non-selecting group. There was a significant difference between non-chemistry selecting male and chemistry selecting male and female while a no significant difference between non-chemistry selecting male and non-chemistry selecting female. However, records of non-chemistry selecting female showed no significant difference with chemistry selecting male and female. This result means that difference of records is not dependent on the chemistry selecting but dependent on the sexual difference. Therefore, the opening of "general chemistry" as preliminary course for organic chemistry and physical chemistry cannot be essential. The attitude on the learning and incentive might be more important factors for the completion of the courses of organic chemistry and physical chemistry.
For the better learning of Korean medical terminology, the use of computer assisted learning program, terminology dictionary in word processor and making a homepage for the terminology were proposed. The method for the realization of above three kinds was also discussed.
I tried to evaluate the curriculum of the Department by students' critics. In December 1990, the questionnaires consisting 9 groups and 50 items were administered to 93 freshmen. The each groups and t he items of questionnaires were summed up with the ranking analysis. The attitude and technique of lecturer, materials for the lectures and laboratory got higher marks. The contents of the lecture and laboratory, and the student's response to lecture and laboratory got lower marks. Out of the specific items, the textbook, number of the assistant personnels, speed of lecture, introduction of the usage of laboratory manual, and number of specimens got the lowest marks. These items must be revised or corrected for the improvement of the education program in the Department. The increase of number of staffs is the most urgent task. This study might be a model for the other Departments in case of evaluating the curriculum by students.
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