Descriptive Analysis of the Psychometric Properties of Extended Matching Questions Conducted Among Anaesthesia Residents

Background: Clinical reasoning is one of the core features of clinical competency. Training and assessing clinical reasoning is vital in post-graduate training. Extended matching questions(EMQs) are effective in assessing problem-solving and clinical reasoning abilities, but not commonly used in Postgraduate training. Covid-۱۹ pandemic, which prevented both patient encounter and regular academic activities, warranted the introduction of innovative Teaching-Learning methods to sustain clinical reasoning skills. Hence, we aimed to introduce EMQs in formative assessment among anaesthesia residents and analyzed its psychometric properties.  Methods: The study was conducted at the Department of Anaesthesiology, MGMCRI, Pondicherry. Four modules of EMQs as part of a formative assessment was conducted among residents (n=۲۰). A total of ۴۰ clinical vignettes and ۶۰ options were administered. Post-validation of the EMQs was done by item analysis. Test reliability was estimated by the Kuder-Richardson ۲۰ formula. Difficulty index(DIF-I), discrimination index(DIS-I), and distractor functionality were analysed. Results: The KR-۲۰ reliability coefficient was ۰.۷۲. The mean DIF-I was ۰.۴۳±۰.۱۷, where ۷۲.۵%(۲۹) were in the acceptable range, ۲۰%(۸) difficult, and ۷.۵%(۳) easy. The mean DIS-I was ۰.۲۸±۰.۲۴, where ۴۰%(۱۶) had acceptable, ۲۷.۵%(۱۱) excellent, and ۲۰% had poor discrimination. Ninety percent of distractors were functional. The DIS-I exhibited a positive correlation with DIF-I (r= ۰.۲۱۵۵, P=۰.۰۱۸۵). Conclusions: The results of the present study indicates that EMQs have acceptable test reliability. The majority of the items (۸۰%) followed the principles of MCQs. We conclude that EMQs can be effectively used as part of the postgraduate assessment to test higher-order knowledge and clinical competency.

Keywords:

Extended matching questions , Item Analysis , Difficulty Index , Clinical competency