title: History and future of the European Board of Ophthalmology Diploma examination.
abstract: OBJECTIVE
  The European Board of Ophthalmology Diploma (EBOD) examination has evolved over the last few years, especially with the introduction of negative marking (-0.5 points) for incorrect or blank answers (0 points for don't know option), which aimed to improve the quality and reliability of the examination.
  
  
  METHODS
  In 2010, negative marking at the written part of the EBOD examination has been introduced in an attempt to improve not only the reliability of the examination as entity but also the statistical performance parameters of the individual questions. As lower pass rates and discrimination of female candidates are feared by the general public when negative marking is concerned, these parameters have been explicitly investigated.
  
  
  RESULTS
  Introduction of negative marking has not only lead to improved reliability of the EBOD examination (increased Cronbach's alpha value: ≤0.80 without and ≥0.90 with negative marking), but also to improved statistical performance parameters of the individual questions. The pass rate of the EBOD examination has proven to remain at the same high level as without negative marking (around 90%). Furthermore, although female candidates do seem to have different answering strategies (p < 0.01, use of don't know option), no statistically significant difference has been found between total scores of male and female candidates (p > 0.05).
  
  
  CONCLUSIONS
  Introduction of negative marking at the written EBOD examination has proven to be beneficial, not only for the organizers (improvement of the statistical performance of the examination and its questions), but also for candidates (better discrimination with borderline candidates). These results have been obtained without evidence of lower pass rates or discrimination of female candidates.
authors.affiliation: Department of Ophthalmology, Antwerp University Hospital, Belgium. danny.mathysen@uza.be
authors.forename: Danny G P
authors.initials: DG
authors.lastname: Mathysen
authors.forename: Wagih
authors.initials: W
authors.lastname: Aclimandos
authors.forename: Ella
authors.initials: E
authors.lastname: Roelant
authors.forename: Kristien
authors.initials: K
authors.lastname: Wouters
authors.forename: Catherine
authors.initials: C
authors.lastname: Creuzot-Garcher
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ringens
authors.forename: Marko
authors.initials: M
authors.lastname: Hawlina
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Tassignon
mesh_terms: D002568:Certification / Q000592:standards*; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement / Q000379:methods*; D005060:Europe; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D009885:Ophthalmology / Q000193:education* / Q000266:history*; D013044:Specialty Boards / Q000639:trends*