BackgroundThe goal of the Objective Structured Clinical Examination (OSCE) in Competency-based Medical Education (CBME) is to establish a minimal level of competence. The purpose of this study was to 1) to determine the credibility and acceptability of the modified Angoff method of standard setting in the setting of CBME, using the Borderline Group (BG) method and the Borderline Regression (BLR) method as a reference standard; 2) to determine if it is feasible to set different standards for junior and senior residents, and 3) to determine the desired characteristics of the judges applying the modified Angoff method.MethodsThe results of a previous OSCE study (21 junior residents, 18 senior residents, and six fellows) were used. Three groups of judges performed the modified Angoff method for both junior and senior residents: 1) sports medicine surgeons, 2) non-sports medicine orthopedic surgeons, and 3) sports fellows. Judges defined a borderline resident as a resident performing at a level between competent and a novice at each station. For each checklist item, the judges answered yes or no for “will the borderline/advanced beginner examinee respond correctly to this item?” The pass mark was calculated by averaging the scores. This pass mark was compared to that created using both the BG and the BLR methods.ResultsA paired t-test showed that all examiner groups expected senior residents to get significantly higher percentage of checklist items correct compared to junior residents (all stations p < 0.001). There were no significant differences due to judge type. For senior residents, there were no significant differences between the cut scores determined by the modified Angoff method and the BG/BLR method. For junior residents, the cut scores determined by the modified Angoff method were lower than the cut scores determined by the BG/BLR Method (all p < 0.01).ConclusionThe results of this study show that the modified Angoff method is an acceptable method of setting different pass marks for senior and junior residents. The use of this method enables both senior and junior residents to sit the same OSCE, preferable in the regular assessment environment of CBME.

The clinical applications of point-of-care ultrasound (US) have expanded rapidly over the past decade. To promote early exposure to point-of-care US, there is widespread support for the integration of US curricula within undergraduate medical education. However, despite growing evidence and enthusiasm for point-of-care US education in undergraduate medical education, the curricular design and delivery across undergraduate medical education programs remain variable without widely adopted national standards and guidelines. This article highlights the educational and teaching applications of point-of-care US with a focus on outcomes. We then review the evidence on curricular design, delivery, and integration and the assessment of competency for point-of-care US in undergraduate medical education.

The MMI provides a reliable way to assess residency candidates that is acceptable to both candidates and assessors across a variety of programs.