title: Repeated use of computerized case simulations in a test format does not present a security risk.
abstract: BACKGROUND
  Computer-based examination formats permit evaluation of patient care strategies in a realistic context. Because such examinations are complex and difficult to develop, the same case simulations must often be used on multiple occasions.
  
  
  METHODS
  To determine if repeated, serial administration of computerized case simulations influences performance, 8 simulations were administered over 2 consecutive years to 252 third-year medical students at the conclusion of 16 surgical clerkship rotations (8 per year). One-way analyses of variance were used to compare scores across rotations during the year and to compare scores between 2 consecutive academic years. Scheffe pairwise comparisons were used to identify trends within each academic year.
  
  
  RESULTS
  The data demonstrate an increase in scores across rotations during the year. There is, however, no difference between scores in successive years.
  
  
  CONCLUSIONS
  The data are consistent with an increase in knowledge during the course of the year, without evidence that test information transfer influences the performance of successive classes.
authors.affiliation: Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha 68198-4395, USA.
authors.forename: T G
authors.initials: TG
authors.lastname: Lynch
authors.forename: R J
authors.initials: RJ
authors.lastname: Zadalis
authors.forename: P D
authors.initials: PD
authors.lastname: Schneider
mesh_terms: D002982:Clinical Clerkship / Q000379:methods*; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D005500:Follow-Up Studies; D013502:General Surgery / Q000193:education*; D006801:Humans; D012189:Retrospective Studies; D012637:Security Measures; D013337:Students, Medical