Abstract
This paper presents and interprets examiner and participant performance data obtained from an experimental field test of the test item and case simulation libraries of the American Board of Emergency Medicine Specialty Certificate Examination. The 94 participants included a sample of 22 fourth year medical students, 36 second year residents in Emergency Medicine, and 36 peer nominated exemplar practicing emergency physicians. Analyses include inter-rater reliability studies, internal consistency (alpha) studies, factor analyses, and generalizability studies of the examiner-participant-simulated patient interactions. The results are interpreted as suggesting that examiners sense the general competence of the participant and do not identify and independently rate specific component skills. Examiners agree with each other and clearly identify case to case variability in performance within subjects and differences in general competence between subjects. Performance evaluations on at least five to seven cases are required for a reasonably accurate estimate of general competence of physicians.
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