title: Investigating the Performance of Second Language Medical Students on Lengthy Clinical Vignettes.
abstract: This study evaluated the extent to which medical students with limited English-language experience are differentially impacted by the additional reading load of test items consisting of long clinical vignettes. Participants included 25,012 examinees who completed Step 2 of the U.S. Medical Licensing Examination®. Test items were categorized into five levels based on the number of words per item, and examinee scores at each level were evaluated as a function of English-language experience (English as a second language [ESL] status and scores on a test of English-speaking proficiency). The longest items were more difficult than the shortest items across all examinee groups, and examinees with more English-language experience scored higher than those with less experience across all five levels of word count. The effect of primary interest-the interaction of word count with English-language experience-was statistically significant, indicating that score declines for longer items were larger for examinees with less English-language experience; however, the magnitude of this interaction effect was barely detectable (η2= .0004, p < .001). Additional analyses supported the conclusion that the differential effect for examinees with less English-language experience was small but worthy of continued monitoring.
authors.affiliation: 1 National Board of Medical Examiners, Philadelphia, PA, USA.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Raymond
authors.affiliation: 1 National Board of Medical Examiners, Philadelphia, PA, USA.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ling
authors.affiliation: 1 National Board of Medical Examiners, Philadelphia, PA, USA.
authors.forename: Irina
authors.initials: I
authors.lastname: Grabovsky
mesh_terms: D002983:Clinical Competence; D004521:Educational Measurement / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D007802:Language; D013337:Students, Medical / Q000706:statistics & numerical data*
keywords: English as a second language; assessment; case-based test items; licensure and certification testing; test fairness