Evidence of gender bias in True-False-Abstain medical examinations

Kelly, Shona; Dennick, Reg

doi:10.1186/1472-6920-9-32

Cited by 29 publications

(30 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Female students were viewed as significantly less confident and more anxious than their male counterparts [12], but results in the realm of clinical performance have not been consistent, regarding an advantage for either female or male students [13][14][15]26]. Despite an advantage of females regarding palpatory diagnostic competencies in our study, students of both genders achieved comparable results during practical manipulative assessment.…”

Section: Discussioncontrasting

confidence: 62%

Knowledge transfer of spinal manipulation skills by student-teachers: a randomised controlled trial

et al. 2012

View full text Add to dashboard Cite

Purpose To assess the use of peer-assisted learning (PAL) of complex manipulative motor skills with respect to gender in medical students. Methods In 2007-2010, 292 students in their 3rd and 4th years of medical school were randomly assigned to two groups [Staff group (SG), PAL group (PG)] led by either staff tutors or student-teachers (ST). The students were taught bimanual practical and diagnostic skills (course education module of eight separate lessons) as well as a general introduction to the theory of spinal manipulative therapy. In addition to qualitative data collection (Likert scale), evaluation was performed using a multiple-choice questionnaire in addition to an objective structured clinical examination (OSCE). Results Complex motor skills as well as palpatory diagnostic competencies could in fact be better taught through professionals than through ST (manipulative OSCE grades/ diagnostic OSCE score; SG vs. PG; male: P = 0.017/ P \ 0.001, female: P \ 0.001/P \ 0.001). The registration of theoretical knowledge showed equal results in students taught by staff or ST. In both teaching groups (SG: n = 147, PG: n = 145), no significant differences were observed between male and female students in matters of manipulative skills or theoretical knowledge. Diagnostic competencies were better in females than in males in the staff group (P = 0.041) Overall, students were more satisfied with the environment provided by professional teachers than by ST, though male students regarded the PAL system more suspiciously than their female counterparts. Conclusions The peer-assisted learning system does not seem to be generally qualified to transfer such complex spatiotemporal demands as spinal manipulative procedures.

show abstract

Section: Discussioncontrasting

confidence: 62%

Knowledge transfer of spinal manipulation skills by student-teachers: a randomised controlled trial

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Recent and older studies in the medical area or in other disciplines in which gender differences were found, with females scoring lower than males, often involved other types of MCQ testing and/or other scoring conditions [5], [18], [19]. A large gender difference was found in eight years of examination data of undergraduate medical students.…”

Section: Resultsmentioning

confidence: 97%

“…MCQ tests may also introduce gender bias in test performance dependent on subject test area, instruction/scoring condition and question difficulty (reviewed in [4]. A different type of MCQ consisting of questions with ‘True-False-Abstain’ answering options only has been reported to introduce significant gender bias within the medicine subject area [5].…”

Section: Introductionmentioning

confidence: 99%

Negatively-Marked MCQ Assessments That Reward Partial Knowledge Do Not Introduce Gender Bias Yet Increase Student Performance and Satisfaction and Reduce Anxiety

et al. 2013

View full text Add to dashboard Cite

Multiple-choice question (MCQ) examinations are increasingly used as the assessment method of theoretical knowledge in large class-size modules in many life science degrees. MCQ-tests can be used to objectively measure factual knowledge, ability and high-level learning outcomes, but may also introduce gender bias in performance dependent on topic, instruction, scoring and difficulty. The ‘Single Answer’ (SA) test is often used in which students choose one correct answer, in which they are unable to demonstrate partial knowledge. Negatively marking eliminates the chance element of guessing but may be considered unfair. Elimination testing (ET) is an alternative form of MCQ, which discriminates between all levels of knowledge, while rewarding demonstration of partial knowledge. Comparisons of performance and gender bias in negatively marked SA and ET tests have not yet been performed in the life sciences. Our results show that life science students were significantly advantaged by answering the MCQ test in elimination format compared to single answer format under negative marking conditions by rewarding partial knowledge of topics. Importantly, we found no significant difference in performance between genders in either cohort for either MCQ test under negative marking conditions. Surveys showed that students generally preferred ET-style MCQ testing over SA-style testing. Students reported feeling more relaxed taking ET MCQ and more stressed when sitting SA tests, while disagreeing with being distracted by thinking about best tactics for scoring high. Students agreed ET testing improved their critical thinking skills. We conclude that appropriately-designed MCQ tests do not systematically discriminate between genders. We recommend careful consideration in choosing the type of MCQ test, and propose to apply negative scoring conditions to each test type to avoid the introduction of gender bias. The student experience could be improved through the incorporation of the elimination answering methods in MCQ tests via rewarding partial and full knowledge.

show abstract

“…In MTFQ [10, 28, 29] students judge the truth of statements or conclusions in the clinical reasoning process. There are serious doubts on the validity of this question type.…”

Section: Resultsmentioning

confidence: 99%

“…Student scores are influenced by exam techniques and willingness to take risks. Research indicates a gender bias in favour of men regarding the question mark option [28]. There is a considerable chance of a correct answer based on the wrong information.…”

Section: Resultsmentioning

confidence: 99%

Preferred question types for computer-based assessment of clinical reasoning: a literature study

Bruggen¹,

Woudenbergh²,

Spierenburg³

et al. 2012

Perspect Med Educ

View full text Add to dashboard Cite

Clinical reasoning is a core competence of doctors. Therefore, the assessment of clinical reasoning of undergraduate students is an important part of medical education. Three medical universities in the Netherlands wish to develop a shared question database in order to assess clinical reasoning of undergraduate students in Computer-Based Assessments (CBA). To determine suitable question types for this purpose a literature study was carried out. Search of ERIC and PubMed and subsequent cross referencing yielded 30 articles which met the inclusion criteria of a focus on question types suitable to assess clinical reasoning of medical students and providing recommendations for their use. Script Concordance Tests, Extended Matching Questions, Comprehensive Integrative Puzzles, Modified Essay Questions/Short Answer Questions, Long Menu Questions, Multiple Choice Questions, Multiple True/False Questions and Virtual Patients meet the above-mentioned criteria, but for different reasons not all types can be used easily in CBA. A combination of Comprehensive Integrative Puzzles and Extended Matching Questions seems to assess most aspects of clinical reasoning and these question types can be adapted for use in CBA. Regardless of the question type chosen, patient vignettes should be used as a standard stimulus format to assess clinical reasoning. Further research is necessary to ensure that the combination of these question types produces valid assessments and reliable test results.

show abstract

Evidence of gender bias in True-False-Abstain medical examinations

Abstract: Background: There is evidence that males and females differ in their attainment on a variety of assessments in general and in medical education. It has been suggested that the True-False-Abstain (TFA) format with negative marking is biased against females.

Cited by 29 publications

References 14 publications

Knowledge transfer of spinal manipulation skills by student-teachers: a randomised controlled trial

Knowledge transfer of spinal manipulation skills by student-teachers: a randomised controlled trial

Negatively-Marked MCQ Assessments That Reward Partial Knowledge Do Not Introduce Gender Bias Yet Increase Student Performance and Satisfaction and Reduce Anxiety

Preferred question types for computer-based assessment of clinical reasoning: a literature study

Contact Info

Product

Resources

About