title: A core component of the certification examination in internal medicine.
abstract: OBJECTIVE
  To develop and test the psychometric characteristics of an examination of core content in internal medicine.
  
  
  METHODS
  A cross-sectional pilot test comparing the core examination with the 1988 certifying examination and two pretest examinations.
  
  
  METHODS
  The 1988 certifying examination of the American Board of Internal Medicine.
  
  
  METHODS
  A random sample of 2,975 candidates from 8,968 candidates who took the 1988 certifying examination were given the core examination; similarly drawn samples were each given one of two pretests of traditional questions.
  
  
  METHODS
  A framework for developing an examination of core internal medicine questions was designed and used to develop a 92-question core test with an absolute pass/fail standard.
  
  
  RESULTS
  Candidates answered 74% of core internal medicine questions, compared with 64%, 52%, and 53% of traditional questions on the 1988 certifying examination and the two pretests. The discriminating ability of the core internal medicine examination was lower than that of the certifying examination (r-values were 0.28 and 0.34, respectively). The pass rate was 83% for the core internal medicine examination and 57% for the certifying examination; 27% passed the core examination and failed the certifying examination; 1% passed the certifying examination and failed the core examination.
  
  
  CONCLUSIONS
  Core internal medicine questions were easier than but almost as discriminating as traditional questions of the certifying examination. A small percentage of candidates passed the certifying examination but failed the core examination.
authors.affiliation: American Board of Internal Medicine, Philadelphia, Pennsylvania.
authors.forename: L O
authors.initials: LO
authors.lastname: Langdon
authors.forename: L J
authors.initials: LJ
authors.lastname: Grosso
authors.forename: S C
authors.initials: SC
authors.lastname: Day
authors.forename: J J
authors.initials: JJ
authors.lastname: Norcini
authors.forename: H R
authors.initials: HR
authors.lastname: Kimball
authors.forename: S W
authors.initials: SW
authors.lastname: Fletcher
mesh_terms: D002568:Certification / Q000592:standards*; D004521:Educational Measurement / Q000592:standards; D007388:Internal Medicine / Q000193:education*; D011594:Psychometrics; D014481:United States