Effect of different scoring approaches upon credit assignment when using Multiple True-False items in dental undergraduate examinations.

INTRODUCTION: Various scoring approaches for Multiple True-False (MTF) items exist. This study aimed at comparing scoring results obtained with different scoring approaches and to assess the effect of item cues on each scoring approaches' result. MATERIALS AND METHODS: Different scoring approaches (MTF, Count-2, Count-3, "Vorkauf-Method," PS50 , Dichotomized MTF, "Blasberg-Method," Multiple response (MR), Correction for Guessing, "Ripkey-Method," Morgan-Method, Balanced Scoring Method) were retrospectively applied to all MTF items used within electronic examinations of undergraduate dental students at the University Medical Center Göttingen in the winter term 2016/2017 (1297 marking events). Item quality was evaluated regarding formal parameters such as presence of cues and correctness of content. Differences between scoring results of all scoring approaches and the differences between each methods' scoring results of items with and without cues were calculated by Wilcoxon rank sum tests (P < .05). RESULTS: Average scoring results per item highly differed between the scoring approaches and ranged from 0.46 (MR) to 0.92 (Dichotomized MTF). Presence of cues leads to significantly higher scoring in case of all scoring approaches (P < .001; +0.14 on average). However, effect of cues differed amongst scoring approaches and ranged from +0.04 (Dichotomized MTF) to +0.20 (MR). CONCLUSION: Scoring of MTF items is complex. The data presented in this manuscript may help educators make informed choices about scoring algorithms.

How can we improve teaching of ECG interpretation skills? Findings from a prospective randomised trial.

BACKGROUND: There is an ongoing debate on how ECG interpretation should be taught during undergraduate medical training. This study addressed the impact of teaching format, examination consequences and student motivation on skills retention. METHODS: A total of 493 fourth-year medical students participated in a six-group, partially randomised trial. Students received three levels of teaching intensity: self-directed learning (2 groups), lectures (2 groups) or small-group peer-teaching (2 groups). On each level of teaching intensity, end-of-course written examinations (ECG exit exam) were summative in one group and formative in the other. Learning outcome was assessed in a retention test two months later. RESULTS: Retention test scores were predicted by summative assessments (adjusted beta 4.08; 95% CI 1.39-6.78) but not by the type of teaching. Overall performance levels and motivation did not predict performance decrease or skills retention. CONCLUSIONS: Summative assessments increase medium-term retention of ECG interpretation skills, irrespective of instructional format.