Emerging tasks of specialty certifying examination: educational measurement considerations

Medical specialty systems were launched in 1951 by the National Medical Services Law. The following year, the specialty certifying examination had implemented in the form of portfolio evaluation. A paper-and-pencil type examination was implemented in 1960, and the 55th examination was carried out in January 2012. Currently, 26 specialties are represented, and the overall pass rate is over 90%. The examination consists of a step 1 paper-and-pencil test and step 2 skills test. In the step 1 test, the test items are multiple choice questions and short answer questions. Clinical performance examination is partially applied to the step 2 test. To cope with changes in the social situation and the growth of medical services, developmental changes are needed in the specialty certifying examinations. Performance assessment is an alternative worth considering. CPX should be a major part of the skill test. A computer-based test should be introduced as soon as possible, and it could eventually be developed into an adaptive test.

A Selection and Translation of Evidence Based Clinical Practice Guidelines for Primary Care Physician in Respiratory Disease Field

BACKGROUND: One method for achieving medical practice to be more evident, especially in the field of primary care, is to encourage the use of clinical guidelines. If development of guidelines is difficult because of time and cost, an evidence based foreign guidelines can be selected and translated into Korean for application. METHODS: A team was formed, consisting of 11 family physician experts on evidence based medicine and clinical practice guidelines. We selected six respiratory diseases requiring clinical guidelines because of variability in practice. We searched several clinical practice guideline databases and selected one guideline according to currency, scope of guideline, whether it was evidence based, and its feasibility in the field of primay care. We translated selected guideline's full-texts or summaries which were done by authorized organization into Korean. RESULTS: The selected respiratory diseases were chronic obstructive pulmonary disease, asthma, pneumonia, sinusitis, rhinitis, and influenza. According to criterion, we selected GOLD (Global Initiative for Chronic Obstructive Lung Disease) for chronic obstructive lung disease, GINA (Global initiative for asthma) for asthma, CDC (Center for disease control) guideline for influenza, IDSA (Infectious Diseases Society of America) guideline for pneumonia, AAP (American Academy of Pediatrics) guideline for sinusitis, and JCAAI (Joint Council of Allergy, Asthma and Immunology) for rhinitis. CONCLUSION: We selected six common respiratory diseases and the most appropriate evidence based guidelines for those particular diseases.

Response Variations to Same Items between Two Consecutive Grades in Medical School Examination / 한국의학교육

In order to compare a group of examinees to other group, the tests taken by two groups of examinees should be equivalent. The first step of the equating the test is to make anchor items. In medical schools, the students prepare the examination through the thorough review of the test items of previous year. So it is said that the reuse of the same items could be undesirable. The purpose of this study is to find out response variations to the same items between two consecutive grades when the items are reused. The senior classes of a medical school are sampled and the test items of graduation examination was analysed. On the basis of item difficulty(item's p-value) and discrimination index, we selected 35 items. Next year, we reused those items to the same examination to the senior class of that year, and the result was analysed. Among those 35 items, 14 items were modified slightly. The averages of the item difficulty and discrimination index on the previous examination were 0.49 and 0.20 which were in the desirable ranges. But at the next year these data were worsened to 0.84 and 0.10 respectively. This trends were not different in the slightly modified items. And there was no significant differences among the item groups classified on the basis of the level of knowledge. We could ascertain that if a previously used item used again to a test, the item difficulty will increase(become easy) and discrimination index will decrease even though minor modification is done.