Research article
Special article on the 20th anniversary of the journal
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Comparison of real data and simulated data analysis of a stopping rule based on the standard error of measurement in computerized adaptive testing for medical examinations in Korea: a psychometric study
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Dong Gi Seo
, Jeongwook Choi
, Jinha Kim
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J Educ Eval Health Prof. 2024;21:18. Published online July 9, 2024
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DOI: https://doi.org/10.3352/jeehp.2024.21.18
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Abstract
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Supplementary Material
- Purpose
This study aimed to compare and evaluate the efficiency and accuracy of computerized adaptive testing (CAT) under 2 stopping rules (standard error of measurement [SEM]=0.3 and 0.25) using both real and simulated data in medical examinations in Korea.
Methods
This study employed post-hoc simulation and real data analysis to explore the optimal stopping rule for CAT in medical examinations. The real data were obtained from the responses of 3rd-year medical students during examinations in 2020 at Hallym University College of Medicine. Simulated data were generated using estimated parameters from a real item bank in R. Outcome variables included the number of examinees’ passing or failing with SEM values of 0.25 and 0.30, the number of items administered, and the correlation. The consistency of real CAT result was evaluated by examining consistency of pass or fail based on a cut score of 0.0. The efficiency of all CAT designs was assessed by comparing the average number of items administered under both stopping rules.
Results
Both SEM 0.25 and SEM 0.30 provided a good balance between accuracy and efficiency in CAT. The real data showed minimal differences in pass/fail outcomes between the 2 SEM conditions, with a high correlation (r=0.99) between ability estimates. The simulation results confirmed these findings, indicating similar average item numbers between real and simulated data.
Conclusion
The findings suggest that both SEM 0.25 and 0.30 are effective termination criteria in the context of the Rasch model, balancing accuracy and efficiency in CAT.
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Citations
Citations to this article as recorded by

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Frontiers in Behavioral Neuroscience.2026;[Epub] CrossRef - Feasibility of applying computerized adaptive testing to the Clinical Medical Science Comprehensive Examination in Korea: a psychometric study
Jeongwook Choi, Sung-Soo Jung, Eun Kwang Choi, Kyung Sik Kim, Dong Gi Seo
Journal of Educational Evaluation for Health Professions.2025; 22: 29. CrossRef