RESUMEN
DESCRIPTION OF THE PROBLEM: High-stakes decision-making should have sound validation evidence; reliability is vital towards this. A short exam may not be very reliable on its own within didactic courses, and so supplementing it with quizzes might help. But how much? This study's objective was to understand how much reliability (for the overall module-grades) could be gained by adding quiz data to traditional exam data in a clinical-science module. THE INNOVATION: In didactic coursework, quizzes are a common instructional strategy. However, individual contexts/instructors can vary quiz use formatively and/or summatively. Second-year PharmD students took a clinical-science course, wherein a 5-week module focused on cardiovascular therapeutics. Generalizability Theory (G-Theory) combined seven quizzes leading to an exam into one module-level reliability, based on a model where students were crossed with items nested in eight fixed testing occasions (mGENOVA used). Furthermore, G-Theory decision-studies were planned to illustrate changes in module-grade reliability, where the number of quiz-items and relative-weighting of quizzes were altered. CRITICAL ANALYSIS: One-hundred students took seven quizzes and one exam. Individually, the exam had 32 multiple-choice questions (MCQ) (KR-20 reliability=0.67), while quizzes had a total of 50MCQ (5-9MCQ each) with most individual quiz KR-20s less than or equal to 0.54. After combining the quizzes and exam using G-Theory, estimated reliability of module-grades was 0.73; improved from the exam alone. Doubling the quiz-weight, from the syllabus' 18% quizzes and 82% exam, increased the composite-reliability of module-grades to 0.77. Reliability of 0.80 was achieved with equal-weight for quizzes and exam. NEXT STEPS: Expectedly, more items lent to higher reliability. However, using quizzes predominantly formatively had little impact on reliability, while using quizzes more summatively (i.e., increasing their relative-weight in module-grade) improved reliability further. Thus, depending on use, quizzes can add to a course's rigor.
RESUMEN
OBJECTIVES: Performance-based assessments, including objective structured clinical examinations (OSCEs), are essential learning assessments within pharmacy education. Because important educational decisions can follow from performance-based assessment results, pharmacy colleges/schools should demonstrate acceptable rigor in validation of their learning assessments. Though G-Theory has rarely been reported in pharmacy education, it would behoove pharmacy educators to, using G-Theory, produce evidence demonstrating reliability as a part of their OSCE validation process. This investigation demonstrates the use of G-Theory to describes reliability for an OSCE, as well as to show methods for enhancement of the OSCE's reliability. INNOVATION: To evaluate practice-readiness in the semester before final-year rotations, third-year PharmD students took an OSCE. This OSCE included 14 stations over three weeks. Each week had four or five stations; one or two stations were scored by faculty-raters while three stations required students' written responses. All stations were scored 1-4. For G-Theory analyses, we used G_Strings and then mGENOVA. CRITICAL ANALYSIS: Ninety-seven students completed the OSCE; stations were scored independently. First, univariate G-Theory design of students crossed with stations nested in weeks (p × s:w) was used. The total-score g-coefficient (reliability) for this OSCE was 0.72. Variance components for test parameters were identified. Of note, students accounted for only some OSCE score variation. Second, a multivariate G-Theory design of students crossed with stations (pâ¢ × s°) was used. This further analysis revealed which week(s) were weakest for the reliability of test-scores from this learning assessment. Moreover, decision-studies showed how reliability could change depending on the number of stations each week. For a g-coefficient >0.80, seven stations per week were needed. Additionally, targets for improvements were identified. IMPLICATIONS: In test validation, evidence of reliability is vital for the inference of generalization; G-Theory provided this for our OSCE. Results indicated that the reliability of scores was mediocre and could be improved with more stations. Revision of problematic stations could help reliability as well. Within this need for more stations, one practical insight was to administer those stations over multiple weeks/occasions (instead of all stations in one occasion).
RESUMEN
DESCRIPTION OF THE PROBLEM: Reliability is critical validation evidence on which to base high-stakes decision-making. Many times, one exam in a didactic course may not be acceptably reliable on its own. But how much might multiple exams add when combined together? THE INNOVATION: To improve validation evidence towards high-stakes decision-making, Generalizability Theory (G-Theory) can combine reliabilities from multiple exams into one composite-reliability (G_String IV software). Further, G-Theory decision-studies can illustrate changes in course-grade reliability, depending on the number of exams and exam-items. CRITICAL ANALYSIS: 101 first-year PharmD students took two midterm-exams and one final-exam in a pharmaceutics course. Individually, Exam1 had 50MCQ (KR-20=0.69), Exam2 had 43MCQ (KR-20=0.65), and Exam3 had 67MCQ (KR-20=0.67). After combining exam occasions using G-Theory, the composite-reliability was 0.71 for overall course-grades-better than any exam alone. Remarkably, increased numbers of exam occasions showed fewer items per exam were needed, and fewer items over all exams, to obtain an acceptable composite-reliability. Acceptable reliability could be achieved with different combinations of number of MCQs on each exam and number of exam occasions. IMPLICATIONS: G-Theory provided reliability critical validation evidence towards high-stakes decision-making. Final course-grades appeared quite reliable after combining multiple course exams-though this reliability could and should be improved. Notably, more exam occasions allowed fewer items per exam and fewer items over all the exams. Thus, one added benefit of more exam occasions for educators is developing fewer items per exam and fewer items over all exams.
