Multiple-choice Exam Research Articles

USMLE Scores Do Not Predict the Clinical Performance of Emergency Medicine Residents

Background: Scores on “high-stakes” multiple choice exams such as the United States Medical Licensing Examination® (USMLE) are important screening and applicant ranking criteria used by residencies.Objective: We tested the hypothesis that USMLE scores do not predict overall clinical performance of emergency medicine (EM) residents.Methods: All graduates from our University-based EM residency between the years 2008 and 2015 were included. Residents who had incomplete USMLE records were terminated, transferred out of the program, or did not graduate within this timeframe were excluded from the analysis. Clinical performance was defined as a gestalt of the residency program’s leadership and was classified into three sets: top, average, and lowest clinical performer. Dissimilarities of the initial blind rankings were adjudicated during a consensus conference.Results: During the eight years of the study period, there were a total of 115 graduating residents: 73 men (63%) and 42 women. Nearly all of them (109; 95%) had allopathic medical degrees; the remainder had osteopathic degrees. There was not a statistically significant correlation between our ranking of clinical performance and the Step 2 Clinical Knowledge score. There was a non-significant correlation between clinical performance and the Step 1 score.Conclusion: Neither USMLE Step 1 nor Step 2 Clinical Knowledge were good predictors of the actual clinical performance of residents during their training. We feel that their scores are overemphasized in the resident selec­tion process.

Automatic Correction of Free Format MCQ Tests

Although the technology for the automatic grading of multiple-choice exams exists, it is neither efficient nor as automatic as it claims to be. All proposed methods have a predefined answer sheet format that looks like a crosswords table or a chessboard. Because of this format, all questions must have the same number of choices. Such an answer sheet is not clear, and candidates taking the exam can and will accidentally mark the wrong cell in the table. Most of them assume that there is only one possible answer for every question. This article proposes an algorithm that does not require any special format, works with all scanning resolutions and is actually fast.

Three Kinds of Humility in Bioethics Certification

The author's skepticism about certifying bioethicists has a 20-year history. The hazards of certification include doubts about whether an online, multiple-choice exam measures what is important in bioethical deliberation. Other worries include the potential neglect of informal reasoning processes used by patients and families, the creation of a false sense of expertise, and how certification can disenfranchise lay members of ethics committees. This essay does not seek to reverse the growing trend toward certification but urges humility both in the process of certification and in interpreting the results. Humility is here defined through the works of Judith Andre and Jack Coulehan. Three kinds of humility are described as important for bioethics work: epistemic, moral, and ontological. The current qualifications for taking the certification exam are discussed, and suggestions for a better approach are offered.

Does difficulty-based item order matter in multiple-choice exams? (Empirical evidence from university students)

This empirical study aimed to investigate the impact of easy first vs. hard first ordering of the same items in a paper and-pencil multiple-choice exam on the performances of low, moderate, and high achiever examinees, as well as on the item statistics. Data were collected from 554 Turkish university students using two test forms, which included the same multiple-choice items ordered reversely, i.e. easy first vs. hard first. Tests included 26 multiple-choice items about the introductory unit of “Measurement and Assessment” course. The results suggested that sequencing the multiple-choice items in either direction from easy to hard or vice versa did not affect the test performances of the examinees no matter whether they are low, moderate or high achiever examinees. Finally, no statistically significant difference was observed between item statistics of both forms, i.e. the difficulty (p), discrimination (d), point biserial (r), and adjusted point biserial (adj. r) coefficients.

The cognitive requirement in the multiple-choice exams in the university context and its relationship with learning approaches, self-regulation, teaching methods and academic performance

The quality of academic performance and learning outcomes depend on various factors, both psychological and contextual. The academic context includes the training activities and the type of evaluation or examination, which also influences cognitive and motivational factors, such as learning and study approaches and self-regulation. In our university context, the predominant type of exam is that of multiple-choice questions. The cognitive requirement of these questions may vary. From Bloom's typical taxonomy, it is considered that from lower to higher cognitive demand we have questions about factual, conceptual, application knowledge, etc. Normally, the teacher does not take these classifications into account when preparing this type of exam. We propose here an adaptation model of the multiple choice questions classification according to cognitive requirement (associative memorization, comprehension, application), putting it to the test analyzing an examination of a subject in Psychology Degree and relating the results with measures of learning approaches (ASSIST and R-SPQ-2F questionnaires) and self-regulation in a sample of 87 subjects. The results show differential academic performance according to "cognitive" types of questions and differences in approaches to learning and self-regulation. The convenience of taking into account these factors of cognitive requirement when elaborating multiple choice questions is underlined.

Online and In-class Team-Based Learning in Undergraduate Immunology: a Comparative Analysis.

The goal of this study was to compare student learning outcomes and preferences using a modified team-based learning (TBL) approach in classroom-based versus online formats in an upper level undergraduate immunology course. Fifty-five students were randomly assigned to small groups and participated in four immunology case study modules either face-to-face in a classroom or synchronously online. In both comparative groups, students completed pre-test Individual Readiness Assurance Test (IRAT) at the beginning of each module in-class or online, discussed cases in-class or online with group members, and completed in-class or online post-test Group Readiness Assurance Test (GRAT) after case study group discussions. Assessment of individual student learning was performed using multiple choice exam questions that addressed concepts from each module. At the end of the course, students completed an optional survey to evaluate course satisfaction and preferences. In all four modules, students performed equally well on the IRATs, regardless of whether they performed TBL in class or online; and students performed better on the GRATs than the IRATs after using the TBL methodology, regardless of whether they performed TBL in class or online. In the application of course concepts, except for modules 2 and 3, there was no difference between a student's performance on the IRAT and the exams, regardless of whether they performed TBL in class or online. There was a significant difference in student perception but not performance when comparing in-class versus online TBL. For almost all measured outcomes, students preferred in-class TBL to online TBL.

Evaluation of a novel curriculum on point-of-care ultrasound competency and confidence.

Point-of-care ultrasound (POCUS) education is a requirement of graduate medical education in EM. Milestones have been established to assess resident US competency. However, the delivery of POCUS education has not been standardized. This study aims to evaluate the impact of implementing a longitudinal, structured POCUS curriculum during EM residency on trainee competency and confidence. A prospective study of PGY-3 trainees before and after implementation of a novel POCUS curriculum was performed over an 18-month period at an EM residency training program. Curriculum design included longitudinal POCUS application-based monthly electronic content, bi-monthly residency conference sessions, and hands-on rotations. PGY-3 resident's POCUS knowledge was assessed with a 38-question multiple-choice and image-based exam. Further, PGY-3 residents were surveyed regarding POCUS confidence. Survey results evaluated provider confidence, satisfaction with the novel curriculum, and overall perception of POCUS utility scored on a 1 (low) to 5 (high) scale. Results were evaluated using an unpaired t test for data analysis. Mean quiz scores of 8 pre-curriculum PGY-3 residents (84%; 95%CI 78.46-89.54) were not significantly different when compared with 13 post-curriculum PGY-3 residents (82%; 95%CI 77.11-86.89) (p = 0.6126). Survey results for pre-curriculum trainees across each section were 4.13 (95%CI 3.91-4.35), 3.68 (95%CI 3.32-4.04), and 4.33 (95%CI 4.06-4.6). Results for post-curriculum trainees trended higher for each section at 4.22 (95%CI 4.04-4.40) (p = 0.4738), 3.84 (95%CI 3.52-4.16) (p = 0.5279), and 4.49 (95%CI 4.21-4.77) (p = 0.4534). Implementation of a structured, longitudinal POCUS curriculum resulted in a trend towards improved trainee confidence, satisfaction, and perception of POCUS. Future studies are needed to identify the optimal structure for POCUS educational content delivery and competency assessment for EM resident providers.

Evaluation of immunohematology knowledge in hematology trainees.

Canadian hematology trainees are expected to attain clinical knowledge in the subject of red blood cell and platelet antigen systems and the principles of transfusion medicine. However, the relative degree of expertise required in blood bank serology is not well defined. A modified Delphi approach involving 10 Canadian hematology program directors was utilized to identify 12 relevant topics in immunohematology. A multiple-choice exam was developed and validated among hematology trainees from 13 hematology training programs across Canada. A Rasch analysis was used to determine fit of the examination before deploying the exam the following year to ascertain the level of knowledge in hematology trainees. The exam was piloted with 62 hematology trainees. The reliability of the exam was 0.93 with a mean item fit score of 1.01. The exam was able to discriminate between training years and self-rated expertise with better performance attained by more advanced trainees (p < 0.01). No differences were seen between geographic regions. A modified version of the exam was deployed the following year to 85 trainees, with a mean score of 58.9% ± 15.3%. Trainees scored poorest on topics concerning antibody investigations and D variants. A standardized exam for assessing hematology trainees on their expected expertise in transfusion immunohematology has been developed and can be used to assess the efficacy of educational resources provided in the subject. Trainees had a low overall mean score indicating additional educational initiatives are warranted.

The Use of Simulation Games and Tabletop Exercises in Disaster Preparedness Training of Emergency Medicine Residents

Introduction:Emergency physicians play a frontline role in hospital disaster responses and require appropriate training.Aim:The aim of the current study was to pilot and compare the effectiveness of two emergency preparedness teaching interventions: the first employing traditional lecture-based instruction (LEC) and the second utilizing interactive simulation/game-based teaching (SIM).Methods:A two-group randomized pre- and post-test design was implemented into the didactic curriculum of the Emergency Medicine (EM) Residency Training Program at the San Lucas Episcopal Hospital in Ponce, Puerto Rico. Residents (n=23) completed either a LEC (control) or SIM teaching module (single day, one to two hours) focusing on emergency preparedness concepts, disaster-related clinical decision-making, and physician responsibilities during hospital disaster protocols. Knowledge-based multiple-choice exams and scenario-based competency exams were administered at three different time points: one-week pre-intervention, immediately post-training, and two-weeks post-training. Test scores were compared between groups at each time point using the Mann-Whitney U test.Results:Following the teaching interventions, no significant differences were found between the LEC group versus the SIM group in knowledge-based exam performance (LEC 81.1%[9.4] vs. SIM 74.9%[12.1]; U=42.50, p=0.15) and scenario-based exam performance (LEC 80.0%[9.7] vs. SIM 80.2%[9.2]; U=62.00, p=0.83), suggesting both teaching methods were similarly effective. Indeed, knowledge-based exam scores improved two-fold and scenario-based exam scores improved by over 50% immediately following training relative to baseline exam scores. Two-weeks post-training, a significant decrease in scenario-based exam performance was found in the LEC group relative to the SIM group (LEC 63.1%[11.6] vs. SIM 75.4%[11.5]; U=91.50, p=0.036), suggesting residents who train with simulations show greater retention of scenario-based concepts compared to those who train with lecture-based training alone.Discussion:The current study highlights the potential dual value of incorporating simulation training in EM emergency preparedness curriculums in improving both knowledge and concept retention of physician disaster responsibilities.

Transfusion Camp: a prospective evaluation of a transfusion education program for multispecialty postgraduate trainees.

The optimal method of providing transfusion medicine (TM) education has not been determined. Transfusion Camp was established in 2012 at the University of Toronto as a centrally delivered TM education program for postgraduate trainees. The impact of Transfusion Camp on knowledge, attitudes, and self-reported behavior was evaluated. Didactic lectures (delivered locally, by webinar, or recorded) and locally facilitated team-based learning seminars were delivered over 5 days during the academic year to 8 sites: 7 in Canada and 1 in the United Kingdom. Knowledge assessment using a validated 20-question multiple-choice exam was conducted before and after Transfusion Camp. Attitudes and self-reported behavior were collected through a survey. Over 2 academic years (July 2016 to June 2018), 390 trainees from 16 different specialties (predominantly anesthesia, 41%; hematology, 14%; and critical care, 7%) attended at least 1 day of Transfusion Camp. The mean pretest score was 10.3 of 20 (±2.9; n = 286) compared with posttest score of 13.0 (±2.8; n = 194; p < 0.0001). Lower pretest score and greater attendance (4-5 days compared with 1-3 days) were associated with larger improvement in posttest score; delivery format, specialty, and postgraduate year were not. Trainees reported an improvement in self-rated abilities to manage TM scenarios; 95% rated TM knowledge as very or extremely important in providing patient care; and 81% indicated that they had applied learning from Transfusion Camp into clinical practice. Transfusion Camp increased TM knowledge, fostered a positive attitude toward TM, and enabled a self-reported positive impact on transfusion practice in postgraduate trainees. It is a novel and scalable approach to delivering TM education.

Does Two‐stage Collaborative Testing Improve Recall and Retention of Anatomical Concepts?

IntroductionAnatomy is a foundational component of biomedical sciences. To directly address concerns regarding retention of anatomical knowledge, course assessments can be redesigned as learning opportunities. Specifically, collaborative two‐stage testing is an alternative to traditional ‘independent’ testing, previously shown to improve final exam performance and retention of course material. However, past evaluations of student retention have generally compared separate cohorts of students who write either an individual test or a two‐stage test; such a design fails to control for between‐student variables.AimBuilding on previous work in the field, the primary aim of this research is to determine the impact of two‐stage collaborative testing on student recall (short‐term) and retention (long‐term) of anatomy knowledge while controlling for between‐student variables by employing a randomized crossover research design. Secondary aims of this research are to compare performance metrics between high and low performing students and evaluate students' perceptions regarding the collaborative testing structure.MethodsAt the initiation of ANAT110 (Anatomy for Medical Radiation Sciences) students (n=94) were randomized into 30 “anatomy groups” (AGs) of 3–4 students. Throughout the course AGs worked together on in‐class and in‐laboratory learning activities, including course assessments. Students were assessed using three segmented term tests (TT; 20% each) and one cumulative final exam (40%). Each TT began with all students individually completing a multiple choice exam (the IND condition). Following this, some students would convene in their AGs to collaboratively complete the same multiple choice exam in a condensed amount of time (the COL condition). To control for learning effects of the collaborative process, all 30 AGs completed TT1 as IND + COL. Experimental testing conditions were TT2 and TT3 (with crossover), where half the class completed an IND examination only and the other half completed an IND + COL examination. Data collection is currently in progress. Using results from an in‐class formative quiz (written 5 days following the TTs), robust 2×2 mixed‐factor statistical analyses will reveal the direct impact of testing condition (IND vs. COL) on anatomy recall. Using individualized final examination performance, segmented and coded for previous testing condition (IND vs. COL), similar statistical analyses will reveal the direct impact of testing condition on anatomy retention.ResultsBased on previous cohort studies, it is hypothesized that two‐stage collaborative testing will improve recall and retention of anatomical concepts. It is also hypothesized that the relative impact on performance will be consistent between low and high performers.ImportanceHolistically evaluating the educational impact and student perceptions of two‐stage collaborative testing is imperative for determining the future utility of this strategy in the context of human anatomy education.Support or Funding InformationA portion of this work is funded by the Learning &amp; Education Advancement Fund (seed grant) through the University of TorontoThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Students Becoming the Teacher: Questioning the Value of Peer‐Taught Lectures on Exam Performance

Peer teaching, i.e. when students teach students, has been shown by literature, from various sources and levels of education, to be an effective educational tool. In anatomical sciences education, peer‐teaching in the gross anatomy laboratory has become the norm due to reduction in curricular hours and limitations associated with cadaver dissection laboratory access. While studies in the laboratory have shown that peer teaching can lead to increased student performance on examinations overall, its effect on the performance of the peer teachers, the learners, and compared to instructor taught content, remain to be elucidated. The aim of this COMIRB exempt (#15‐042), retrospective study was to assess the educational impact of peer teaching on learning outcomes of the peer teachers themselves and their peer students. Further, the assessment outcomes between the peer‐taught versus instructor‐taught contents were compared to determine the educational efficacy of peer teaching. During fall semesters of 2014–2016, students in an anatomical sciences graduate program were randomly assigned into groups of 3–4 students and assigned an embryology topic to teach the class. Learning objectives were provided to students by the course instructor; students were told exam questions would stem from learning objectives. All students took the same multiple‐choice exams throughout the course, and all exams were written by the course instructor to test both peer‐taught and instructor‐taught topics. At the end of the course, perceived values of peer teaching experience and peer‐taught lessons were assessed via surveys. 60 data sets were acquired for analyses. Performance of peer teachers on exam items related to their lecture topic was compared to the performance of students who attended the peer‐taught lecture using two‐tailed T tests. Peer teachers performed significantly better (P &lt; 0.05) on exam items they taught than their peers. Students' average performance on peer‐taught exam items was compared to students' performance on instructor‐taught exam items using a paired two‐tailed T‐test which revealed that students performed significantly better (P &lt; 0.05) on instructor‐taught exam items than on peer‐taught exam items. Survey analysis revealed that students perceive the peer‐teaching activity to be effective for their learning, but peer‐taught lectures were ineffective. Thematic analysis of the survey comments identified competencies such as deep learning, team work, self‐directed learning as the positive aspects of the peer‐teaching experience. Students indicated large time commitment for preparing the lecture, varied teaching effectiveness of peer teachers, ineffective group dynamics and desire to learn from the professional instructor, as negative aspects of the peer‐teaching project. The current study reveals that peer‐teaching is beneficial for the peer‐teachers but not as beneficial for the students compared to the instructor delivered lectures. Peer‐teaching activities may need reevaluation or standardization to ensure all student receive the high quality of instruction.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The TEAM (Trauma Evaluation and Management) course: medical student knowledge gains and retention in the USA versus Ghana

IntroductionTrauma and injury are significant contributors to the global burden of disease, with 5 million deaths and 250 million disability-adjusted life years lost in 2015. This burden is disproportionally borne...

Metaphors on Open-Ended Question and Multiple-Choice Tests Produced by Pre-Service Classroom Teachers

Abstract Open-ended exams and multiple-choice exams are two types of examinations that are highly preferred in educational sciences. They have several advantages in terms of their characteristics, and they also have some limitations. These advantages and limitations affect the use of these exams both in national exams and in the exams administered by teachers in their classes. The purpose of the present research is revealing the perceptions of the candidates of the classroom teachers by means of metaphors. The research was carried in accordance with qualitative research methods and designs. The research was designed according to phenomenology. The study group consisted of 355 pre-service classroom teachers. According to the findings of the present research, pre-service classroom teachers produced 240 metaphors related to open-ended and multiple-choice exams. The metaphors produced by the pre-service classroom teachers related to the classical open-ended exams were grouped under 13 categories, while the metaphors for multiple choice exams were grouped under a total of 10 categories. The most frequently used metaphors produced for open-ended examinations were “freedom in answering” (24.5%), “requiring knowledge” (20.4%) and “negative association” (11.2%), while for the multiple-choice exams these were “offering options” (28.8%) and “chance success” (20.4%).

Incorporating Quality Improvement into Resident Education: Structured Curriculum, Evaluation, and Quality Improvement Projects

Quality Improvement (QI) is essential for improving health care delivery and is now a required component of neurosurgery residency. However, neither a formal curriculum nor implementation strategies have been established by the Accreditation Council for Graduate Medical Education. We describe our experience with implementing a formal QI curriculum, including structured didactics and resident led group-based QI projects. Course materials and didactics were provided by the Mayo Quality Academy. Participants were required to take a 30-question multiple-choice exam to demonstrate basic proficiency in QI methods following completion of didactic. An anonymous survey also was performed to elicit feedback from course participants. All of the 40 student participants (17 residents) were able to demonstrate basic proficiency in QI methods on a standardized exam upon course completion. Of the 9 attempted QI projects, 7 were completed, with 5 of those resulting in sustained process changes. The majority of participants felt formal training improved confidence in QI processes and was a valuable professional tool for their careers. A formal didactic curriculum and practical application of QI methodologies adds value to resident training. Further, it has the potential to positively impact practice. Consideration should be given to adopting a formal QI curriculum by other neurosurgery departments and perhaps standardization on national level.

One Small Step for Step 1.

Step 1 of the United States Medical Licensing Examination (USMLE) is a multiple-choice exam primarily measuring knowledge about foundational sciences and organ systems. The test was psychometrically designed as pass/fail for licensing boards to decide whether physician candidates meet minimum standards they deem necessary to obtain the medical licensure necessary to practice. With an increasing number of applicants to review, Step 1 scores are commonly used by residency program directors to screen applicants, even though the exam was not intended for this purpose. Elsewhere in this issue, Chen and colleagues describe the "Step 1 climate" that has evolved in undergraduate medical education, affecting learning, diversity, and well-being.Addressing issues related to Step 1 is a challenge. Various stakeholders frequently spend more time demonizing one another rather than listening, addressing what lies under their respective control, and working collaboratively toward better long-term solutions. In this Invited Commentary, the author suggests how different constituencies can act now to improve this situation while aspirational future solutions are developed.One suggestion is to report Step 1 and Step 2 Clinical Knowledge scores as pass/fail and Step 2 Clinical Skills scores numerically. Any changes must be carefully implemented in a way that is mindful of the kind of unintended consequences that have befallen Step 1. The upcoming invitational conference on USMLE scoring (InCUS) will bring together representatives from all stakeholders. Until there is large-scale reform, all stakeholders should commit to taking (at least) one small step toward fixing Step 1 today.

Improving the Training Process of Anesthesiology Residents Through the Mentorship-Based Approach.

BackgroundAlthough mentoring has been accepted as an effective and nourishing component in medical learning, known mentoring programs for the residents are lacking in most countries.ObjectivesTo evaluate the mentoring program for anesthesiology residents at Shahid Beheshti University, an examination was designed to explore the styles of mentoring programs, as well as the aims and outcome followed by such programs.MethodsIn October 2016, Anesthesiology Department of Shahid Beheshti University of Medical Sciences enrolled all the nine educational wards in “mentorship program”. Twelve members of the faculty were chosen to be mentor. This program contained: (a) Creating online groups for reporting, feedbacks, and problem-solving, (b) integrating each chapter of textbooks for studying program each month, (c) establishing formative and summative assessments (i.e., PMP, OSCE, multiple choice exams), (d) role-playing for stress management of level 4 residents. Our main objective was to provide the residents with the provision of mentors. The goals of our programs were: Arrange a safe environment to encourage and foster reflection, promote self-care and wellness, guide special development, provide a resource for residents pursuing control, enrich team constructing and problem-solving skills, and promotion in career counseling of anesthesia residents at Shahid Beheshti University of Medical Sciences enrolled in this program from 2014 to 2017. We retrospectively compared 2 periods before (2014 - 2015) and after (2016 - 2017) of monthly examination and educational conference.ResultsIn the academic stage from 2014 - 2015, the overall first-time license rate for the IBA written QE was 7 of 14 (50%) and in the period of 2016 - 2017, the general rate was 11 of 14 (78%) and in the period of 2017 - 2018, it was 12 of 14 (85%). For each extra year experiencing the program, the odds ratio for passing IBA written QE was 1.7 (P < 0.05). The median Iranian Board of Anesthesiology In-Training Examination (IBAITE) percentile was considerably greater in period 2 than period 1 (P < 0.05). Also, there was a significant correlation between IBAITE score and first-time passing rates for the IBA written QE (0.55, P < 0.05).ConclusionsThe results of this study demonstrated the clinical mentorship program as an effective method in improving theoretical, clinical, and professional achievement of anesthesiology residents. Programmed mentorship could significantly improve the educational goal achievements for anesthesiology residents. Mentoring programs are needed to be more used; however, need to be assessed and evaluated, especially regarding the professional aspects of education. Medical schools could subsequently be assessed regarding the number and quality of their running mentorship programs as a quality improvement tool.

APLIKASI UJIAN AKHIR SEMESTER BERBASIS ONLINE PADA SMK MANDIRI MAKASSAR

Conventional test process has many constraints that is cheating and cheating is still often the case. Besides the slowness of the assessment process in conventional exams due to participants that much that can inhibit teachers in incorporating values into report cards. The purpose of this research is to design based semester final exam application online at Milwaukee Public CMS in order to simplify the Makassar Independent parties in organizing school exams due to online exam developed in computerization, so constraints conventional test can be resolved. Online exam system on this type of exam consists of multiple choice and essay in which to type multiple choice exam, participants can directly know the exam results shortly after the test took place.

On the relationship between regulatory focus and response bias in multiple-choice exams

Regulatory focus is a strong predictor for a person’s behaviour in signal detection tasks. While a promotion focus is related to a risky response strategy (hits, false alarms), a prevention focus is associated with a conservative strategy (correct rejections, misses). The present research is based on the assumption that multiple-choice (MC) examinations represent typical signal-detection situations. It includes six studies that examined the effect of students’ regulatory focus on their test-taking response bias in MC items with a multiple true–false format. Altogether, the results support the hypothesized association between promotion focus and the tendency to make errors of commissions (rather than omissions), and conditioned evidence for the hypothesized association between promotion focus and the tendency to confirm (rather than negate) test items. Findings concerning prevention focus were heterogeneous. In sum, this research extends the generalizability of the predictions from regulatory focus theory to the context of MC examinations.

MSK30: a validated tool to assess clinical musculoskeletal knowledge

BackgroundMusculoskeletal (MSK) complaints comprise a large proportion of outpatient visits. However, multiple studies show that medical school curriculum often fails to adequately prepare graduates to diagnose and manage common MSK...