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Basic Item Analysis By Bob McMullen, MS, PA-C Associate Professor AT Still University Mesa, AZ [email protected] 2011 PAEA Annual Education Forum Objectives At the end of this session, the participant will be able to: 1. Define the following terms as they apply to excam and item analysis: a. Stem, answer and distractors b. Item difficulty and discrimination c. Distractor analysis d. Reliability and validity 2. Describe how each of the above metrics is obtained from Scantron or LMS software and/or spreadsheet functions 3. Describe how each of the above metrics can be analyzed and compared Disclaimers The speaker doesn’t receive any money from anybody except his wifeand she doesn’t get anything from Scantron or any other companies mentioned in this talk. Step 1- Write a Test Open-book, closedbook or combination?? Parts of a MCQ Title Title: Lid Lag Stem Lid lag is associated with which condition? Correct Answer a. Narrow-angle glaucoma *b. Hyperthyroidism c. Presbyopia d. Hypothyroidism e. Open-angle glaucoma Distractors Step 2: Give the Test Note to Self: Mention importance of scratch paper Step 3: Grade Test Image from Scantron.com Step 4: Print the Analysis Image from Scantron.com Step 4a: Examine the Analysis Screen capture from Blackboard Learning System (WebCT) Step 4a: Examine the Analysis Screen capture from Blackboard Learning System (WebCT) Step 5: Determine Exam Mean Image from Scantron.com Step 5: Determine Exam Mean Screen capture from Blackboard Learning System (WebCT) Step 6: Examine Question Difficulty • Difficulty is the percentage of students that got the question correct • It is denoted as “p” Step 6: Examine Question Difficulty Highlight questions that may be too difficult Too difficult defined by number of answer choices: 2 alternatives (true/false)= .75 or 75% 3 alternative MCQ= .67 or 67% 4 alternative MCQ= .63 or 63% 5 alternative MCQ= .60 or 60% Step 6: Examine Question Difficulty Highlight questions that may be too difficult Too difficult defined by number of answer choices: 2 alternatives (true/false)= .75 or 75% 3 alternative MCQ= .67 or 67% 4 alternative MCQ= .63 or 63% 5 alternative MCQ= .60 or 60% Step 7: Locate or Calculate Response Distribution Step 7: Locate or Calculate Response Distribution Screen capture from Blackboard Learning System (WebCT) Step 7: Locate or Calculate Response Distribution Step 8: Transfer Difficulty, Discrimination, and Response Distribution values to Each Question P=54% r=44 Step 8: Transfer Difficulty, Discrimination, and Response Distribution values to Each Question r=44 • • • Discrimination is the item’s ability to discriminate between students who did well on the exam and those that didn’t It is the difference between the difficulty for the upper part of the group and the lower part It is denoted as “r” Step 8: Transfer Difficulty, Discrimination, and Response Distribution values to Each Question r=44 • • • • 40-100= Excellent item 25-39= Good item 0-24= Usually unacceptable- might be approved Negative= Unacceptable, check item for error Step 8: Transfer Difficulty, Discrimination, and Response Distribution values to Each Question Step 9: Examine Each Question with SME Title: 00-001-013-1 2. Which of the following is NOT a feature of P-glycoproteins in the intestine? a. Act as extruding transporters *b. Enhance absorption of drugs from GI lumen c. Remove substances from enterocytes d. Have inhibitors and inducers e. Act on a substrate 14 38 15 2 2 P=54% r=44 • • • • Difficulty? Discriminator? Response Distribution? Validity? • • • • 40-100= Excellent item 25-39= Good item 0-24= Usually unacceptablemight be approved Negative= Unacceptable, check item for error Step 9: Examine Each Question with SME Title: 00-002-003-5 3. What single factor affects drug binding to receptors the most? *a. Drug concentration b. Drug solubility c. Drug Molecular size d. Receptor lipophilicity e. Receptor polarity 33 29 0 2 7 P=47% r=28 • • • • Difficulty? Discriminator? Response Distribution? Validity? • • • • 40-100= Excellent item 25-39= Good item 0-24= Usually unacceptablemight be approved Negative= Unacceptable, check item for error Step 9: Examine Each Question with SME 38 4 27 2 0 Title: 01.001.005-1 6. A patient presents with severe abdominal pain and "burning" epigastric discomfort. Endoscopy reveals benign ulcers in the antral mucosa of the stomach. Which of the following medications will provide the fastest, albeit probably the briefest, relief of the discomfort with just a single dose? *a. Magnesium hydroxide b. Cimetidine c. Misoprostol • d. Omeprazole e. Dicyclomine • P=54% r=39 • • • • Difficulty? Discriminator? Response Distribution? Validity? • • 40-100= Excellent item 25-39= Good item 0-24= Usually unacceptablemight be approved Negative= Unacceptable, check item for error Step 9: Examine Each Question with SME 0 11 0 42 18 Title: Pharm-00.004.003-4 9. A 42-year-old female presents with acute left ankle pain which she describes as 3/10. After a thorough physical exam and X-rays, you diagnose a mild ankle sprain. Her history includes GERD for which she takes omeprazole daily. In addition to heat/ice, crutches, elevation and physical therapy, which of the following medications is the most appropriate management for this patient? a. Strong opioid agonist b. Weak opioid agonist c. Mixed opioid agonist-antagonist *d. APAP e. NSAID P=59% r=-5.56 • • • • Difficulty? Discriminator? Response Distribution? Validity? • • • • 40-100= Excellent item 25-39= Good item 0-24= Usually unacceptablemight be approved Negative= Unacceptable, check item for error Step 9: Examine Each Question with SME Title: 01.009.003-25 11. Which of the following classes of drugs used in constipation works by providing indigestible, hydrophilic colloids that absorb water, forming an emollient gel that distends the colon and promotes peristalsis? a. Stool softeners b. Osmotic laxatives *c. Bulk-forming laxatives d. Stool lubricants 2 24 43 2 P=61% r=28 • • • • Difficulty? Discriminator? Response Distribution? Validity? • • • • 40-100= Excellent item 25-39= Good item 0-24= Usually unacceptablemight be approved Negative= Unacceptable, check item for error Step 9: Examine Each Question with SME Title: 02.003.001-25 15. Which of following classes of antidepressants slow cardiac conduction and are the most cardiotoxic? a. SSRIs b. MAOIs *c. TCAs d. SNRIs e. Atypical antidepressants 0 33 33 2 3 P=47% r=33 • • • • Difficulty? Discriminator? Response Distribution? Validity? • • • • 40-100= Excellent item 25-39= Good item 0-24= Usually unacceptablemight be approved Negative= Unacceptable, check item for error Step 10: Check other questions’ Discrimination values r=-5.56 r=0 r=0 Step 10: Check other questions’ Discrimination values 64 0 2 4 1 • • • • Title: 00-001-006-2 1. Which of the following drug administration routes would be expected to take the longest in terms of achieving a high serum drug concentration? *a. Oral b. Intravenous c. Subcutaneous d. Intramuscular e. Inhalation P=90% r=-5.56 Difficulty? Discriminator? Response Distribution? Validity? • • • • 40-100= Excellent item 25-39= Good item 0-24= Usually unacceptablemight be approved Negative= Unacceptable, check item for error Step 10: Check other questions’ Discrimination values Title: 00.005.002-4 5. Why is the location of the patient when the drug is dispensed important in the topic of antimicrobial resistance? a. Antibiotics may have different levels of effectiveness in different climates b. Antibiotics dispensed to a patient standing in WalMart are likely to not work c. Patients in out-patient settings are more likely to finish their prescription *d. Patients in in-patient settings have much higher compliance rates than out-patient e. Patients from New York will not respond to treatment provided in Arizona 9 0 2 60 0 • • • • Difficulty? Discriminator? Response Distribution? Validity? P=85% r=0 • • • • 40-100= Excellent item 25-39= Good item 0-24= Usually unacceptablemight be approved Negative= Unacceptable, check item for error Step 10: Check other questions’ Discrimination values Title: Pharm-00.004.008-25 10. A patient in your surgery rotation uses fentanyl (Duragesic) for chronic pain. She now also has additional moderate pain from the minor surgery your team just performed. Of the following analgesic options, which would be the BEST choice to manage this patient's pain? *a. Hydrocodone/APAP (Lortab) b. Acetaminophen (Tylenol) c. Hydromorphone (Dilaudid) d. Naproxen (Naprosyn) e. Celecoxib (Celebrex) 45 8 10 7 1 P=63% r=0 • • • • Difficulty? Discriminator? Response Distribution? Validity? • • • • 40-100= Excellent item 25-39= Good item 0-24= Usually unacceptablemight be approved Negative= Unacceptable, check item for error Step 11: Regrade Exam and Re-evaluate Image from Scantron.com References Flynn, M. K., & Reese, J. L. (1988). Development and evaluation of classroom tests: A practical application. Journal of Nursing Education, 27(2), 61-65. Jenkins, H. M., & Michael, M. M. (1986). Using and interpreting item analysis data... Valuable tool in test construction. Nurse Educator, 11(1), 10-14. Kuang, H. P. (1952). A critical evaluation of the relative efficiency of three techniques in item analysis. Educational and Psychological Measurement, 12, 248-266. McGahee, T. W., & Ball, J. (2009). How to read and really use an item analysis. Nurse Educator, 34(4), 166-171. Wood, R. (1977). Multiple choice: A state of the art report. Evaluation in Education: International Progress, 1(3), 191-280.