Setting pass scores for assessment of technical performance by surgical trainees.

ABSTRACT

BACKGROUND: One of the major challenges of competency-based training is defining a score representing a competent performance. The objective of this study was to set pass scores for the Objective Structured Assessment of Technical Skill. METHODS: Pass scores for the examination were set using three standard setting methods applied to data collected prospectively from first-year surgical residents (trainees). General surgery residents were then assigned an overall pass-fail status for each method. Using a compensatory model, residents passed the eight station examinations if they met the overall pass score; using a conjunctive model, residents passed if they met the overall pass score and passed at least 50 per cent of the stations. The consistency of the pass-fail decision across the three methods, and between a compensatory and conjunctive model, were compared. RESULTS: Pass scores were stable across all three methods using data from 513 residents, 133 of whom were general surgeons. Consistency of the pass-fail decision across the three methods was 95.5 and 93.2 per cent using compensatory and conjunctive models respectively. Consistency of the pass-fail status between compensatory and conjunctive models for all three methods was also very high (91.7, 95.5 and 96.2 per cent). CONCLUSION: Consistency in pass-fail status between the various methods builds evidence of validity for the set scores. These methods can be applied and studied across a variety of assessment platforms, helping to increase the use of standard setting for competency-based training.