Steven M. Downing

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A taxonomy of 31 multiple-choice item-writing guidelines was validated through a logical process that included two sources of evidence: the consensus achieved from reviewing what was found in 27 textbooks on educational testing and the results of 27 research studies and reviews published since 1990. This taxonomy is mainly intended for classroom assessment.(More)
CONTEXT All assessments in medical education require evidence of validity to be interpreted meaningfully. In contemporary usage, all validity is construct validity, which requires multiple sources of evidence; construct validity is the whole of validity, but has multiple facets. Five sources--content, response process, internal structure, relationship to(More)
The purpose of this research was to study the effects of violations of standard multiple-choice item writing principles on test characteristics, student scores, and pass-fail outcomes. Four basic science examinations, administered to year-one and year-two medical students, were randomly selected for study. Test items were classified as either standard or(More)
BACKGROUND Establishing credible, defensible, and acceptable passing scores for performance-type examinations in real-world settings is a challenge for health professions educators. Our purpose in this article is to provide step-by-step instructions with worked examples for 5 absolute standard-setting methods that can be used to establish acceptable passing(More)
CONTEXT Item response theory (IRT) measurement models are discussed in the context of their potential usefulness in various medical education settings such as assessment of achievement and evaluation of clinical performance. PURPOSE The purpose of this article is to compare and contrast IRT measurement with the more familiar classical measurement theory(More)
CONTEXT All assessment data, like other scientific experimental data, must be reproducible in order to be meaningfully interpreted. PURPOSE The purpose of this paper is to discuss applications of reliability to the most common assessment methods in medical education. Typical methods of estimating reliability are discussed intuitively and(More)
OBJECTIVE The purpose is to provide initial validation of a novel simulation model's fidelity and ability to assess competence in colonoscopy skills. METHODS In a prospective, cross-sectional design, each of 39 endoscopists (13 staff, 13 second year fellows, and 13 novices) performed a colonoscopy on a novel bovine simulation model. Staff endoscopists(More)
Physicians in the United States are required to complete a minimum number of continuing medical education (CME) credits annually. The goal of CME is to ensure that physicians maintain their knowledge and skills throughout their medical career. The New England Journal of Medicine (NEJM) provides its readers with the opportunity to obtain weekly CME credits.(More)
BACKGROUND Psychological distress is common among medical students but manifests in a variety of forms. Currently, no brief, practical tool exists to simultaneously evaluate these domains of distress among medical students. The authors describe the development of a subject-reported assessment (Medical Student Well-Being Index, MSWBI) intended to screen for(More)