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Chapter Highlights
Quality assurance in written tests not only is important for the validity and defensibility of the outcomes but also leads to improved organizational expertise.
The quality of written items mainly depends on two aspects: the creativity, relevance, and engaging nature of the content, and the adherence to item construction rules to minimize false positive and false negative responses.
Even when the outcome of the assessment may be numerical or quantitative scores, quality cannot be quantified. If quality relates to issues such as creativity, relevance, and the mitigation of item construction flaws it is by nature a so-called shared narrative.
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ORIENTATION TO THE CHAPTER
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Regardless of whether a medical school uses a more traditional assessment program or a programmatic assessment approach, there is likely to be a component that uses written assessment. For the assessment program as a whole, to lead to defensible, credible and fair decisions, all its components need to be of good quality, because both passing and failing students unjustly is detrimental.
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Deciding whether a student is ready to progress is not the only purpose of assessment. Essential for education is the provision of feedback and guidance on learning, so these are important aspects of assessment as well.
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What all these purposes have in common is that they require a good assessment program, and this cannot be guaranteed without a rigorous process of quality assurance. This chapter presents the various aspects involved in quality assurance specifically tailored to written assessment.
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INTRODUCTION—PURPOSE OF ASSESSMENT
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Assessing students is not a goal in itself; it is always done for a specific purpose. The quality of an assessment activity therefore starts with a clear understanding of its purpose. Purposes can firstly be defined in terms of the consequences—what the assessment is trying to achieve.
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The most obvious purpose is to determine whether the learner or candidate has achieved a satisfactory level of competence, skills, knowledge, and so on. This can be an important determinant in whether a candidate is ready to enter medical school, progress to the next phase in learning, or graduate and care for patients.
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Assessment will also drive student study behavior and learning. The content of the assessment, the type of assessments, when they are administered, and the rules and regulations around them will have an impact on students’ study behavior [1–3]. Although we sometimes chide students for being assessment driven, this reaction is natural and has always been the case. Consequently, we need to ensure that content, format, programming, and regulatory structure are such that they drive students’ study behavior in the desired direction. For example, because continuous learning leads to better uptake, retention, and access to learned material than block learning, more continuous assessment programs are preferable with or without final examinations.
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