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Biomedical subjects

R J Nungester

Publications and source records attributed to R J Nungester.

14 recordsLinked to original sources
PubMed2000

Review of the score-reporting policy for the United States Medical Licensing Examination.

In 1998, the authors, acting on behalf of the National Board of Medical Examiners (NBME), undertook a review of the scoring policy for the United States Medical Licensing Examination (USMLE). The main goal was to determine the likely effect of changing from numeric score reporting to reporting pass-fail status. Several groups were surveyed across the nation to learn how they felt they would be affected by such a change, and why: all 54 medical boards; 1,600 randomly selected examinees (including 250 foreign medical graduates) who had recently taken either Step 1, Step 2, or Step 3 of the USMLE; 2,000 residency directors; the deans, education deans, and student affairs deans at all 125 U.S. medical schools accredited by the Liaison Committee on Medical Education; and all 17 members of the Council of Medical Specialty Societies. Responses from the different groups surveyed varied from 80% to a little less than half. The authors describe in detail the various views of the respondents and their reasons. Some members in each group favored each of the reporting formats, but the trend was to favor numeric score reporting. The majority of the responding examinees desired that their USMLE scores be sent to them in numeric form but sent to their schools and to residency directors in pass-fail form. Based on the responses and a thorough discussion of their implications, the Composite Committee (which determines USMLE score-reporting policy) decided that there is no basis at this time for changing the current policy, but that it would review the policy in the future when necessary.

Clinical Competence↗
PubMed1997

Setting standards on performance assessments of physicians' clinical skills using contrasting groups and receiver operating characteristic curves.

During recent years, the use of performance assessments for high-stakes evaluation of physicians' clinical skills has increased. As a result, considerable attention has been given to the identification of appropriate procedures for setting standards on performance assessments. Several articles have described application of the contrasting groups procedure. It appears that the procedure is not well understood. Relatively little has been written about the requirements for using this procedure appropriately. This article provides a discussion of the theoretical framework for setting standards using contrasting groups. The discussion is then extended to include the circumstance in which the contrasting groups data are interpreted using receiver operating characteristic curves. Examples from the research literature involving variations on the contrasting groups method for setting standards on performance assessments of clinical skills are discussed. The article concludes with guidelines for evaluators interested in using the contrasting groups procedure.

Clinical Competence↗
PubMed1994

Performance on the National Board of Medical Examiners. Part I Examination by men and women of different race and ethnicity.

OBJECTIVE: To investigate the performance of men and women from various racial and ethnic backgrounds on the National Board of Medical Examiners Part I examination, controlling for any differences in measures of educational background and academic performance before entering medical school. DESIGN: A retrospective analysis of existing records from the National Board of Medical Examiners and the Association of American Medical Colleges. SETTING: National Board of Medical Examiners. PARTICIPANTS: All students taking the June administration of Part I for the first time in 1986, 1987, or 1988 and who were 2 years from graduation from an accredited medical school. METHODS: Multiple regression methods were used to estimate Part I examination group differences in performance that would be expected if all students entered medical school with similar Medical College Admission Test scores, undergraduate grade point averages, and other prematriculation measures. MAIN OUTCOME MEASURE: Performance on the Part I examination. RESULTS: There were substantial differences in performance, with white students scoring highest, followed by Asian/Pacific Islanders, Hispanics, and blacks; within all racial and ethnic categories, women scored lower than men. Controlling for dissimilarities in academic background greatly reduced Part I differences among most racial and ethnic groups, except Asian/Pacific Islander men; unexplained differences remained between men and women. Results were consistent for the 3 years examined. CONCLUSIONS: The results of this study do not imply that physician performance varies among racial and ethnic groups or between men and women; no written examination can measure all the abilities that may be desirable to assess. Validity research investigating reasons for the reported gender and racial and ethnic differences in performance on the National Board examinations should be continued.

Achievement↗
PubMed1991

Standard-setting plans for the NBME comprehensive Part I and Part II examinations.

The National Board of Medical Examiners (NBME) has reviewed its procedure for setting pass-fail standards in conjunction with the introduction of its comprehensive Part I and Part II examinations in 1991. This report gives background information on the procedures used for the past decade to set pass-fail standards for the Part I and Part II examinations, an overview of the NBME's research on standard setting, under way since 1987, and a statement of its plans for determining pass-fail standards for these examinations. In 1981 the NBME changed from the norm-referenced standard, used since the 1950s, to a criterion-group approach to setting pass-fail standards. Although the criterion-group system resulted in more stable standards, it still meant that the standard moved whenever the performance of the reference group changed. After conducting research, surveying constituencies, and examining alternatives, the NBME has adopted a new standard-setting plan that has the following components: a content-based standard-setting procedure; determination of standards by an appropriate group; use of a fixed standard; and periodic review of standards and standard-setting procedures. This new process will produce three types of improvements: it will incorporate deliberations informed by a wide range of information, including content review; annual review of examinees' performances and pass-fail results and triennial restudy of the process will add further quality control; and a fixed standard will mean that comparable performances will be required across administrations in order to pass.

Education, Medical, Undergraduate↗
PubMed1991

Assessment of constituency opinion about NBME examination standards.

The National Board of Medical Examiners (NBME) reviewed its procedures for setting pass-fail standards in conjunction with the introduction of its comprehensive Part I and Part II examinations in 1991. A component of the review was the 1990 survey of 12 NBME constituencies to assess opinions about pass-fail rates and standard setting. The survey responses, generally consistent across groups, revealed (1) support for a more even distribution of fail rates across the three examinations, (2) support for a fixed standard, with pass-fail rates that change depending on the performance of a cohort of examinees, and (3) a favorable reaction to setting performance standards based on a review of the examination content. These responses may serve as a resource and a frame of reference for determining the standards for the comprehensive Part I and Part II examinations.

Attitude↗
PubMed1990

Score reporting on NBME examinations.

Because the National Board of Medical Examiners (NBME) will introduce new comprehensive Part I and Part II examinations in 1991, a review has been made of score reporting methods to be used in the new examinations. The review was conducted also because of concern expressed by some that NBME examination scores are misused in medical schools and in resident selection. In this paper, selected aspects of score reporting are defined, the uses of score reports outlined, and the potential for misuse described. It should be noted that the NBME is obliged to make available numerical scores to state medical boards and to examinees. Individual scores are reported to others only with the permission of the examinee. The results of an opinion poll conducted by the NBME of medical educators and medical students are presented. The range of opinion is broad but favors numerical score reporting and a designated pass/fail score.

Attitude of Health Personnel↗