title: Evidence-based decision about test scoring rules in clinical anatomy multiple-choice examinations.
abstract: In theory the formula scoring methods increase the reliability of multiple-choice tests in comparison with number-right scoring. This study aimed to evaluate the impact of the formula scoring method in clinical anatomy multiple-choice examinations, and to compare it with that from the number-right scoring method, hoping to achieve an evidence-based decision about test scoring rules. Two hundred and ninety-eight students completed an examination in clinical anatomy which included 40 multiple-choice questions with five response options each. Among these, 245 (82.2%) examinees were assessed according to the number-right scoring method (group A) while 53 (17.8%) were assessed according to the formula scoring method (group B). The prevalence of passing was significantly higher in group A than in group B, after correction of the pass and fail cutoffs for guessing (84.9% vs. 62.3%, P = 0.005), keeping a similar reliability in both groups (0.7 vs. 0.8, P = 0.094). Pearson Correlation coefficients between practical and theoretical examination scores were 0.66 [95%CI = (0.58-0.73)] and 0.72 [95%CI = (0.56-0.83)] for groups A and B, respectively. Based solely on the reliability and validity assessments, the test-maker could therefore use either scoring rules; however, if the test-maker also takes into account the students' ability to deduce answers with partial knowledge, then the number-right score rule is most appropriate.
authors: Department of Medical Education and Simulation, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, University of Porto, Porto, Portugal.
authors: Milton
authors: M
authors: Severo
authors: A Rita
authors: AR
authors: Gaio
authors: Ana
authors: A
authors: Povo
authors: Fernanda
authors: F
authors: Silva-Pereira
authors: Maria Amélia
authors: MA
authors: Ferreira
mesh_terms: D000328:Adult; D000715:Anatomy / Q000193:education*; D002755:Choice Behavior; D003657:Decision Making; D004504:Education, Medical, Undergraduate / Q000379:methods; D004521:Educational Measurement / Q000592:standards*; D006801:Humans; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards*; D013337:Students, Medical
keywords: assessment of performance; decision making; educational measurement; examinations; formula scoring; medical education; methodology; number-right scoring