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Mohammad Jalili 1 Article
Sequential Objective Structured Clinical Examination based on item response theory in Iran  
Sara Mortaz Hejri, Mohammad Jalili
J Educ Eval Health Prof. 2017;14:19.   Published online September 8, 2017
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AbstractAbstract PDF
In a sequential objective structured clinical examination (OSCE), all students initially take a short screening OSCE. Examinees who pass are excused from further testing, but an additional OSCE is administered to the remaining examinees. Previous investigations of sequential OSCE were based on classical test theory. We aimed to design and evaluate screening OSCEs based on item response theory (IRT).
We carried out a retrospective observational study. At each station of a 10-station OSCE, the students’ performance was graded on a Likert-type scale. Since the data were polytomous, the difficulty parameters, discrimination parameters, and students’ ability were calculated using a graded response model. To design several screening OSCEs, we identified the 5 most difficult stations and the 5 most discriminative ones. For each test, 5, 4, or 3 stations were selected. Normal and stringent cut-scores were defined for each test. We compared the results of each of the 12 screening OSCEs to the main OSCE and calculated the positive and negative predictive values (PPV and NPV), as well as the exam cost.
A total of 253 students (95.1%) passed the main OSCE, while 72.6% to 94.4% of examinees passed the screening tests. The PPV values ranged from 0.98 to 1.00, and the NPV values ranged from 0.18 to 0.59. Two tests effectively predicted the results of the main exam, resulting in financial savings of 34% to 40%.
If stations with the highest IRT-based discrimination values and stringent cut-scores are utilized in the screening test, sequential OSCE can be an efficient and convenient way to conduct an OSCE.


Citations to this article as recorded by  
  • Utility of eye-tracking technology for preparing medical students in Spain for the summative objective structured clinical examination
    Francisco Sánchez-Ferrer, J.M. Ramos-Rincón, M.D. Grima-Murcia, María Luisa Sánchez-Ferrer, Francisco Sánchez-del Campo, Antonio F. Compañ-Rosique, Eduardo Fernández-Jover
    Journal of Educational Evaluation for Health Professions.2017; 14: 27.     CrossRef

JEEHP : Journal of Educational Evaluation for Health Professions