Objective: The National Board of Chiropractic Examiners (NBCE) uses a robust system for data analysis. The aim of this work is to introduce the reader to the process of score production and the quantitative methods used by the psychometrician and data analysts of the NBCE. Methods: The NBCE employs data validation, diagnostic analyses, and item response theory–based modeling of responses to estimate test takers' abilities and item-related parameters. For this article, the authors generated 1303 synthetic item responses to 20 multiple-choice items with 4 response options to each item. These data were used to illustrate and explain the processes of data validation, diagnostic item analysis, and item calibration based on item response theory. Results: The diagnostic item analysis is presented for items 1 and 5 of the data set. The 3-parameter logistic item response theory model was used for calibration. Numerical and graphical results are presented and discussed. Conclusion: Demands for data-driven decision making and evidence-based effectiveness create a need for objective measures to be used in educational program reviews and evaluations. Standardized test scores are often included in that array of objective measures. With this article, we offer transparency of score production used for NBCE testing.
Objective: This article introduces changes made to the diagnostic imaging (DIM) domain of the Part IV of the National Board of Chiropractic Examiners examination and evaluates the effects of these changes in terms of item functioning and examinee performance. Methods: To evaluate item function, classical test theory and item response theory (IRT) methods were employed. Classical statistics were used for the assessment of item difficulty and the relation to the total test score. Item difficulties along with item discrimination were calculated using IRT. We also studied the decision accuracy of the redesigned DIM domain. Results: The diagnostic item analysis revealed similarity in item function across test forms and across administrations. The IRT models found a reasonable fit to the data. The averages of the IRT parameters were similar across test forms and across administrations. The classification of test takers into ability (theta) categories was consistent across groups (both norming and all examinees), across all test forms, and across administrations. Conclusion: This research signifies a first step in the evaluation of the transition to digital DIM high-stakes assessments. We hope that this study will spur further research into evaluations of the ability to interpret radiographic images. In addition, we hope that the results prove to be useful for chiropractic faculty, chiropractic students, and the users of Part IV scores.
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