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Lucky guess or knowledge: a cross-sectional study using the Bland and Altman analysis to compare confidence-based testing of pharmacological knowledge in 3rd and 5th year medical students

Content Provider	Springer Nature Link
Author	Kampmeyer, Daniela Matthes, Jan Herzig, Stefan
Copyright Year	2014
Abstract	Multiple-choice-questions are common in medical examinations, but guessing biases assessment results. Confidence-based-testing (CBT) integrates indicated confidence levels. It has been suggested that correctness of and confidence in an answer together indicate knowledge levels thus determining the quality of a resulting decision. We used a CBT approach to investigate whether decision quality improves during undergraduate medical education. 3rd- and 5th-year students attended formative multiple-choice exams on pharmacological issues. Students were asked to indicate their confidence in a given answer. Correctness of answers was scored binary (1-correct; 0-wrong) and confidence levels were transformed to an ordinal scale (guess: 0; rather unsure: 0.33; rather sure: 0.66; very sure: 1). 5th-year students gave more correct answers (73 ± 16 vs. 49 ± 13 %, p < 0.05) and were on average more confident regarding the correctness of their answers (0.61 ± 0.18 vs. 0.46 ± 0.13, p < 0.05). Correlation of these parameters was stronger for 5th-year students (r = 0.81 vs. r = 0.52), but agreement of confidence and correctness (‘centration’) was lower. By combining the Bland-and-Altman approach with categories of decision-quality we found that 5th-year students were more likely to be ‘well-informed’ (41 vs. 5 %), while more 3rd-students were ‘uninformed’ (24 vs. 76 %). Despite a good correlation of exam results and confidence in given answers increased knowledge might be accompanied by a more critical view at the own abilities. Combining the statistical Bland-and-Altman analysis with a theoretical approach to decision-quality, more advanced students are expected to apply correct beliefs, while their younger fellows are rather at risk to hesitate or to act amiss.
Starting Page	431
Ending Page	440
Page Count	10
File Format	PDF
ISSN	13824996
Journal	Advances in Health Sciences Education
Volume Number	20
Issue Number	2
e-ISSN	15731677
Language	English
Publisher	Springer Netherlands
Publisher Date	2014-08-08
Publisher Place	Dordrecht
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Bland and Altman-analysis Confidence-based testing Multiple-choice-question Medical Education
Content Type	Text
Resource Type	Article
Subject	Education Medicine

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