Abstract
This study investigated the effect of clinically relevant multiple-choice item content on the valid discrimination or statistical separation of groups with known and different levels of experience and training in emergency medicine. Items for a high-clinical-relevance (HCR) subscale were chosen for their highest correlation with independent ratings of clinical performance on 12 simulated patient encounters relevant to emergency medicine. Low-clinical-relevance (LCR) subscale items were selected for their lowest correlation with the same criterion ratings. HCR was significantly more statistically discriminating of candidate groups which differed with respect to years of training and experience in emergency medicine. Additionally, the HCR subscale was more reliable and less difficult than the LCR subscale.
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