Progressive clinical case-based multiple-choice questions: An innovative way to evaluate and rank undergraduate medical students.

INTRODUCTION: In France, at the end of the sixth year of medical studies, students take a national ranking examination including progressive clinical case-based multiple-choice questions (MCQs). We aimed to evaluate the ability of these MCQs for testing higher-order thinking more than knowledge recall, and to identify their characteristics associated with success and discrimination. METHODS: We analysed the 72 progressive clinical cases taken by the students in the years 2016-2019, through an online platform. RESULTS: A total of 72 progressive clinical cases (18 for each of the 4 studied years), corresponding to 1059 questions, were analysed. Most of the clinical cases (n=43, 60%) had 15 questions. Clinical questions represented 89% of all questions, whereas basic sciences questions accounted for 9%. The most frequent medical subspecialties were internal medicine (n=90, 8%) and infectious diseases (n=88, 8%). The most frequent question types concerned therapeutics (26%), exams (19%), diagnosis (14%), and semiology (13%). Level 2 questions ("understand and apply") accounted for 59% of all questions according to the Bloom's taxonomy. The level of Bloom's taxonomy significantly changed over time with a decreasing number of level 1 questions ("remember") (P=0.04). We also analysed the results of the students among 853 questions of training ECNi. Success and discrimination significantly decreased when the number of correct answers increased (P<0.0001 both). The success, discrimination, mean score, and mean number of discrepancies did not differ according to the diagnosis, exam, imaging, semiology, or therapeutic type of questions. CONCLUSION: Progressive clinical case-based MCQs represent an innovative way to evaluate undergraduate students.

Analysis of the French national evaluation of radiology residents.

PURPOSE: In France, a national evaluation is given annually to radiology residents. The aim of this study was to perform both a docimological analysis of the quality of the questionnaire and a statistical analysis of the results. MATERIALS AND METHODS: This retrospective study, which included French radiology residents from Year 1 to Year 5 of residency, was performed from 2015 to 2017 across 25 medical universities in France. Both qualitative and quantitative docimological analyses were performed as assessed by the Cronbach alpha coefficient, the difficulty of question (PDI), and the coefficient of discrimination (Rir). Results to the questionnaire were compared between years of residency. RESULTS: The results of the analysis confirmed the quality of the questionnaire (Cronbach alpha coefficient=0.71, mean [PDI=0.40]) though the majority of questions could be answered by memory rather than cognitive ability. The mean Rir was 0.02, indicating that students could not be certified using only the questionnaire. The results measuring resident level of knowledge were moderate, with mean results ranging from 9.2/20 at the first year to 11.3/20 at the fifth year of residency (P<0.001). There were no significant differences in results obtained between the third, fourth, and fifth year of residency but results were significantly different among university hospitals. CONCLUSION: Even if close interactions exist between learning and pedagogic environment, our results suggest that it may be useful to further develop an evaluation process in relation with pedagogic instructions in order to provide more optimal training.

Aproximación a un estudio genealógico de la evaluación en Colombia, siglo XX / Aproximação a um estudo genealógico da avaliação na Colômbia, século XX / Approach to a genealogical study of evaluation in Colombia, XX century

Tres problematizaciones articulan la pesquisa: Describir las formas como la evaluación ha signado este lapso de la historia de la educación colombiana (mediante el análisis de las condiciones que permitieron la conformación y consolidación de un saber con pretensiones de autonomía). Rastrear la génesis de los acontecimientos que han posibilitado su emergencia, instalación y operación mediante determinadas prácticas de poder; esta intencionalidad implicó el análisis de los regímenes que han permitido su instalación, su normalización, su permanente presencia; y la especificación de los modos de accionar en los marcos de las denominadas sociedades disciplinaria y de control. Identificar las modalidades de sujetos que produce y gestiona, en razón al establecimiento y a la legitimación de relaciones objetivas-subjetivas, intersubjetivas e interinstitucionales.

Três problematizações articulam esta pesquisa: Descrever as maneiras como a avaliação tem definido este lapso da história da educação colombiana (mediante a analise das condições que permitiram a conformação e a consolidação de um saber com pretensões de autonomia). Seguir a gênese dos acontecimentos que têm possibilitado sua emergência, instalação e consolidação mediante determinadas práticas de poder. Esta intencionalidade implicou a analise dos regimes que têm permitido sua instalação, normalização e sua presencia permanente, como também a especificação dos modos de acionar nas perspectivas das denominadas sociedades disciplinaria e de controle. Identificar as modalidades dos sujeitos que produze e providencia, com referência ao estabelecimento e à legitimação de relações objetivas-subjetivas, intersubjetivas e interinstitucionais.

Three problematizations are considered in this research: to describe the ways how evaluation has characterized this lapse in the history of Colombian education (by means of the analysis of the conditions that allowed the conformation and consolidation of knowledge with autonomy pretensions). To trace the genesis of the events that have made possible its emergence, installation and operation through various power practices; this intentionality implied the analysis of the regimes that have facilitated its installation, normalization and its permanent presence, and the specification of the action modes from the perspective of the so-called disciplinary and control societies. Finally, to identify the modality of the subjects produced and managed by education, with reference to the establishment and legitimization of objective-subjective, inter-subjective and inter-institutional relations.