Psychometric properties of the Ethiopian national licensing exam in medicine: an analysis of multiple-choice questions using classical test theory.

: The Ethiopian Ministry of Health introduced medical licensure examinations to maintain high standards in medical practice and build public trust in healthcare professionals. Studies also suggested significant issues in clinical competence among Ethiopian junior doctors as well concerns regarding unlicensed practice. Given the need to ensure safe health care, we investigated the psychometric properties of the multiple-choice items comprising the Ethiopian national licensing exam (NLE).

Experts' prediction of item difficulty of multiple-choice questions in the Ethiopian Undergraduate Medicine Licensure Examination.

Background: The ability of an expert's item difficulty ratings to predict test-taker actual performance is an important aspect of licensure examinations. Expert judgment is used as a primary source of information for users to make prior decisions to determine the pass rate of test takers. The nature of raters involved in predicting item difficulty is central to set credible standards.

Anaphylaxis in a Swiss university emergency department: clinical characteristics and supposed triggers.

Background: Anaphylaxis is the most severe form of acute systemic and potentially life-threatening reactions triggered by mast and basophilic cells. Recent studies show a worldwide incidence between 50 and 112 occurrences per 100,000 person-years. The most identified triggers are food, medications, and insect venoms.

Inconsistencies in rater-based assessments mainly affect borderline candidates: but using simple heuristics might improve pass-fail decisions.

Introduction: Research in various areas indicates that expert judgment can be highly inconsistent. However, expert judgment is indispensable in many contexts. In medical education, experts often function as examiners in rater-based assessments.

No knowledge gap in human physiology after remote teaching for second year medical students throughout the Covid-19 pandemic.

The COVID-19 pandemic had a disruptive effect on higher education. A critical question is whether these changes affected students' learning outcomes. Knowledge gaps have consequences for future learning and may-in health professionals' education-also pose a threat to patient safety.

Children With Developmental Language Disorder Have Lower Quality of Life Than Children With Typical Development and Children With Cochlear Implants.

Purpose: The purpose of this study was to examine quality of life (QOL) and its relation to language skills in children with developmental language disorder (DLD). This was examined by comparing QOL to a control group of children with typical development (TD), as well as children with cochlear implants (CIs), who potentially struggle with language for language, although for a different reason than children with DLD.

Method: Two groups of children, a group with TD ( = 29) and a group of children with CIs ( = 29), were matched to the DLD group ( = 29) on chronological age, gender, nonverbal IQ, and parental educational level through a propensity matching procedure.

Longitudinal Covid-19 effects on child mental health: vulnerability and age dependent trajectories.

Background: Few longitudinal studies have investigated the extended long-term impact of the Covid-19 pandemic for children's and adolescents' mental health, and a lack of uniform findings suggest heterogeneity in the impact of the pandemic.

Methods: This study investigated child and adolescent mental health symptoms across four occasions (pre-pandemic, initial lockdown, second lockdown, and society post reopening) using data from the Dynamics of Family Conflict study. Child and adolescent depressive vulnerability, age, and sex were explored as trajectory moderators.

Is language an issue? Accuracy of the German computerized diagnostic decision support system ISABEL and cross-validation with the English counterpart.

Objectives: Existing computerized diagnostic decision support tools (CDDS) accurately return possible differential diagnoses (DDx) based on the clinical information provided. The German versions of the CDDS tools for clinicians (Isabel Pro) and patients (Isabel Symptom Checker) from ISABEL Healthcare have not been validated yet.

Methods: We entered clinical features of 50 patient vignettes taken from an emergency medical text book and 50 real cases with a confirmed diagnosis derived from the electronic health record (EHR) of a large academic Swiss emergency room into the German versions of Isabel Pro and Isabel Symptom Checker.

The linguistic complexity of adult and child contextualized and decontextualized talk.

The association between decontextualized talk (DT; i.e., talk extending beyond immediate context) and child language outcomes is well-attested but not well-understood.

Effects of a computerised diagnostic decision support tool on diagnostic quality in emergency departments: study protocol of the DDx-BRO multicentre cluster randomised cross-over trial.

Introduction: Computerised diagnostic decision support systems (CDDS) suggesting differential diagnoses to physicians aim to improve clinical reasoning and diagnostic quality. However, controlled clinical trials investigating their effectiveness and safety are absent and the consequences of its use in clinical practice are unknown. We aim to investigate the effect of CDDS use in the emergency department (ED) on diagnostic quality, workflow, resource consumption and patient outcomes.

Use of epinephrine in anaphylaxis: a retrospective cohort study at a Swiss university emergency department.

Aims Of The Study: Anaphylaxis is a medical emergency and requires prompt treatment to prevent life-threatening conditions. Epinephrine, considered as the first-line drug, is often not administered. We aimed first to analyse the use of epinephrine in patients with anaphylaxis in the emergency department of a university hospital and secondly to identify factors that influence the use of epinephrine.

Social communication and quality of life in children using hearing aids.

Objectives: This study compared the parent-reported structural language and social communication skills-measured with the Children's Communication Checklist-2 (CCC-2)-and health-related quality of life (HR-QOL)-measured with the Pediatric Quality of Life Inventory (PedsQL)-of children who use hearing aids (HAs) and their typical-hearing (TH) peers.

Design: The participants were 88 children (age range of 5; 6 to 13; 1 (years; months)) and their parents: 45 children with bilateral moderate to severe hearing loss using HAs who had no additional disabilities and 43 children with typical hearing. The groups were matched based on chronological age, gender, nonverbal IQ, and parental education level.

Differential diagnosis checklists reduce diagnostic error differentially: A randomised experiment.

Introduction: Wrong and missed diagnoses contribute substantially to medical error. Can a prompt to generate alternative diagnoses (prompt) or a differential diagnosis checklist (DDXC) increase diagnostic accuracy? How do these interventions affect the diagnostic process and self-monitoring?

Methods: Advanced medical students (N = 90) were randomly assigned to one of four conditions to complete six computer-based patient cases: group 1 (prompt) was instructed to write down all diagnoses they considered while acquiring diagnostic test results and to finally rank them. Groups 2 and 3 received the same instruction plus a list of 17 differential diagnoses for the chief complaint of the patient.

Do different response formats affect how test takers approach a clinical reasoning task? An experimental study on antecedents of diagnostic accuracy using a constructed response and a selected response format.

The use of response formats in assessments of medical knowledge and clinical reasoning continues to be the focus of both research and debate. In this article, we report on an experimental study in which we address the question of how much list-type selected response formats and short-essay type constructed response formats are related to differences in how test takers approach clinical reasoning tasks. The design of this study was informed by a framework developed within cognitive psychology which stresses the importance of the interplay between two components of reasoning-self-monitoring and response inhibition-while solving a task or case.

How sure can we be that a student really failed? On the measurement precision of individual pass-fail decisions from the perspective of Item Response Theory.

Background: In high-stakes assessments in medical education, the decision to let a particular participant pass or fail has far-reaching consequences. Reliability coefficients are usually used to support the trustworthiness of assessments and their accompanying decisions. However, coefficients such as Cronbach's Alpha do not indicate the precision with which an individual's performance was measured.

Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality - a retrospective study from a Swiss university hospital.

Aims Of The Study: While COVID-19 significantly overburdens emergency rooms (ERs) and hospitals in affected areas, ERs elsewhere report a marked decrease in patient numbers. This study aimed to investigate the assumption that patients with urgent problems currently avoid the ER.

Methods: Electronic health records from the ER of a large Swiss university hospital were extracted for three periods: first, the awareness phase (ap) from the publication of the national government’s initiative “How to protect ourselves” on 1 March 2020 to the lockdown of the country on 16 March; second, the mitigation phase (mp) from 16–30 March; finally, patients presenting in March 2019 were used as a control group.

Progress testing anytime and anywhere - Does a mobile-learning approach enhance the utility of a large-scale formative assessment tool?

Background: The widespread use of mobile devices among students favors the use of mobile learning scenarios at universities. In this study, we explore whether a time- and location-independent variant of a formative progress test has an impact on the students' acceptance, its validity and reliability and if there is a difference in response processes between the two exam conditions.

Methods: Students were randomly assigned to two groups of which one took the test free of local or temporal fixations, while the other group took the test at the local testing center under usual examination conditions.

What determines diagnostic resource consumption in emergency medicine: patients, physicians or context?

Objectives: A major cause for concern about increasing ED visits is that ED care is expensive. Recent research suggests that ED resource consumption is affected by patients' health status, varies between physicians and is context dependent. The aim of this study is to determine the relative proportion of characteristics of the patient, the physician and the context that contribute to ED resource consumption.

Measurement precision at the cut score in medical multiple choice exams: Theory matters.

Introduction: In high-stakes assessment, the measurement precision of pass-fail decisions is of great importance. A concept for analyzing the measurement precision at the cut score is conditional reliability, which describes measurement precision for every score achieved in an exam. We compared conditional reliabilities in Classical Test Theory (CTT) and Item Response Theory (IRT) with a special focus on the cut score and potential factors influencing conditional reliability at the cut score.

Long-Term Language Development in Children With Early Simultaneous Bilateral Cochlear Implants.

Objectives: This longitudinal study followed the language development of children who received the combination of early (5 to 18 months) and simultaneous bilateral cochlear implants (CIs) throughout the first 6 years after implantation. It examined the trajectories of their language development and identified factors associated with language outcomes.

Design: Participants were 21 Norwegian children who received bilateral CIs between the ages of 5 and 18 mo and 21 children with normal hearing (NH) who were matched to the children with CIs on age, sex, and maternal education.

Diagnostic error increases mortality and length of hospital stay in patients presenting through the emergency room.

Background: Diagnostic errors occur frequently, especially in the emergency room. Estimates about the consequences of diagnostic error vary widely and little is known about the factors predicting error. Our objectives thus was to determine the rate of discrepancy between diagnoses at hospital admission and discharge in patients presenting through the emergency room, the discrepancies' consequences, and factors predicting them.

Accuracy of self-monitoring: does experience, ability or case difficulty matter?

Context: The ability to self-monitor one's performance in clinical settings is a critical determinant of safe and effective practice. Various studies have shown this form of self-regulation to be more trustworthy than aggregate judgements (i.e.