Background: It is widely recognised that deficiencies in fetal surveillance practice continue to contribute significantly to the burden of adverse outcomes. This has prompted the development of evidence-based clinical practice guidelines by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and an associated Fetal Surveillance Education Program to deliver the associated learning. This article describes initial steps in the validation of a corresponding multiple-choice assessment of the relevant educational outcomes through a combination of item response modelling and expert judgement.

These data reveal important deficiencies in the provision and quality of current IFS education practices in Victoria, particularly in smaller and rural hospitals. However, these deficiencies seem to reflect a lack of opportunity rather than a lack of interest.

After a 'needs assessment', in 2004 the Royal Australian and New Zealand College of Obstetricians and Gynaecologists developed and introduced the Fetal Surveillance Education Program (FSEP) to provide high quality education to all clinicians caring for labouring women in Australia and New Zealand. A formal evaluation of the program was planned from the inception of FSEP. We report here the participant feedback from the first 4439 participants in 2004-2006. Overall, FSEP was considered a high quality resource, rated equally well by midwives and obstetricians. This is the first large-scale evaluation to be reported for any fetal surveillance education program.

BackgroundDespite the widespread use of multiple-choice assessments in medical education assessment, current practice and published advice concerning the number of response options remains equivocal. This article describes an empirical study contrasting the quality of three 60 item multiple-choice test forms within the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Fetal Surveillance Education Program (FSEP). The three forms are described below.MethodsThe first form featured four response options per item. The second form featured three response options, having removed the least functioning option from each item in the four-option counterpart. The third test form was constructed by retaining the best performing version of each item from the first two test forms. It contained both three and four option items.ResultsPsychometric and educational factors were taken into account in formulating an approach to test construction for the FSEP. The four-option test performed better than the three-option test overall, but some items were improved by the removal of options. The mixed-option test demonstrated better measurement properties than the fixed-option tests, and has become the preferred test format in the FSEP program. The criteria used were reliability, errors of measurement and fit to the item response model.ConclusionsThe position taken is that decisions about the number of response options be made at the item level, with plausible options being added to complete each item on both psychometric and educational grounds rather than complying with a uniform policy. The point is to construct the better performing item in providing the best psychometric and educational information.

Background: Structured feedback is an important component of learning and assessment and is highly valued by candidates. Unfortunately, item specific feedback is generally not feasible for high stakes professional assessments due to the high cost of item development and the need to maintain stable assessment performance characteristics. In a high stakes assessment of fetal surveillance knowledge, we sought to use graphical item mapping to allow informative candidate feedback without compromising the item bank.