title: Varying levels of difficulty index of skills-test items randomly selected by examinees on the Korean emergency medical technician licensing examination.
abstract: OBJECTIVE
  The goal of this study was to characterize the difficulty index of the items in the skills test components of the class I and II Korean emergency medical technician licensing examination (KEMTLE), which requires examinees to select items randomly.
  
  
  METHODS
  The results of 1,309 class I KEMTLE examinations and 1,801 class II KEMTLE examinations in 2013 were subjected to analysis. Items from the basic and advanced skills test sections of the KEMTLE were compared to determine whether some were significantly more difficult than others.
  
  
  RESULTS
  In the class I KEMTLE, all 4 of the items on the basic skills test showed significant variation in difficulty index (P<0.01), as well as 4 of the 5 items on the advanced skills test (P<0.05). In the class II KEMTLE, 4 of the 5 items on the basic skills test showed significantly different difficulty index (P<0.01), as well as all 3 of the advanced skills test items (P<0.01).
  
  
  CONCLUSIONS
  In the skills test components of the class I and II KEMTLE, the procedure in which examinees randomly select questions should be revised to require examinees to respond to a set of fixed items in order to improve the reliability of the national licensing examination.
authors.affiliation: Dongnam Health University, Suwon, Korea.
authors.forename: Bongyeun
authors.identifier: 0000-0001-7515-3288
authors.initials: B
authors.lastname: Koh
authors.affiliation: Dongnam Health University, Suwon, Korea.
authors.forename: Sunggi
authors.identifier: 0000-0001-5677-2219
authors.initials: S
authors.lastname: Hong
authors.affiliation: Sunlin University, Pohang, Korea.
authors.forename: Soon-Sim
authors.identifier: 0000-0002-1655-963X
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Sunlin University, Pohang, Korea.
authors.forename: Jin-Sook
authors.identifier: 0000-0001-5642-5153
authors.initials: JS
authors.lastname: Hyun
authors.affiliation: Korea National University of Transportation, Chungju, Korea.
authors.forename: Milye
authors.identifier: 0000-0002-6423-942X
authors.initials: M
authors.lastname: Baek
authors.affiliation: Kongju National University, Gongju, Korea.
authors.forename: Jundong
authors.identifier: 0000-0003-4742-8744
authors.initials: J
authors.lastname: Moon
authors.affiliation: Gwangju Health University, Gwangju, Korea.
authors.forename: Hayran
authors.identifier: 0000-0002-3378-8151
authors.initials: H
authors.lastname: Kwon
authors.affiliation: Yangpyeong Fire Station, Gyeonggi-do, Korea.
authors.forename: Gyoungyong
authors.identifier: 0000-0001-6390-6975
authors.initials: G
authors.lastname: Kim
authors.affiliation: Korea Coast Guard Academy, Jeollanam-do, Korea.
authors.forename: Seonggi
authors.identifier: 0000-0001-6360-5857
authors.initials: S
authors.lastname: Min
authors.affiliation: Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea.
authors.forename: Gu-Hyun
authors.identifier: 0000-0003-0128-4175
authors.initials: GH
authors.lastname: Kang
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D004521:Educational Measurement / Q000379:methods* / Q000592:standards; D004522:Educational Status; D004634:Emergency Medical Technicians / Q000193:education*; D006801:Humans; D008004:Licensure / Q000592:standards*; D015203:Reproducibility of Results; D056910:Republic of Korea
keywords: Emergency medical technicians, Item; Korea, Licensure; Reliability