Effect of first-encounter pretest on pass/fail rates of a clinical skills medical licensure examination

Adv Health Sci Educ Theory Pract. 2010 May;15(2):219-27. doi: 10.1007/s10459-009-9193-z. Epub 2009 Sep 13.


Due to the high-stakes nature of medical exams it is prudent for test agencies to critically evaluate test data and control for potential threats to validity. For the typical multiple station performance assessments used in medicine, it may take time for examinees to become comfortable with the test format and administrative protocol. Since each examinee in the rotational sequence starts with a different task (e.g., simulated clinical encounter), those who are administered non-scored pretest material on their first station may have an advantage compared to those who are not. The purpose of this study is to investigate whether pass/fail rates are different across the sequence of pretest encounters administered during the testing day. First-time takers were grouped by the sequential order in which they were administered the pretest encounter. No statistically significant difference in fail rates was found between examinees who started with the pretest encounter and those who encountered the pretest encounter later in the sequence. Results indicate that current examination administration protocols do not present a threat to the validity of test score interpretations.

MeSH terms

  • Clinical Competence / standards*
  • Education, Medical / methods*
  • Educational Measurement / methods*
  • Female
  • Humans
  • Licensure, Medical / standards*
  • Male
  • Reproducibility of Results