Item analysis and evaluation in the examinations in the faculty of medicine at Ondokuz Mayis University

The Evidence Base in Exercise Knowledge of Pregnant Women: A Latent Class Analysis

BACKGROUND

Exercise has many benefits for women with uncomplicated pregnancies. However, poor exercise knowledge may contribute to problems or barriers that reduce a woman's level of exercise after becoming pregnant.

AIM

This study was performed to identify pregnancy exercise knowledge among pregnant women using latent class analysis and to examine the relationship between pregnancy exercise knowledge patterns and sociodemographic characteristics.

DESIGN

A descriptive, cross-sectional approach was used in this study.

METHODS

Participants were recruited from the prenatal outpatient departments of two hospitals and a certified prenatal center in Taipei, Taiwan. A total of 618 participants completed a pregnancy exercise knowledge test. The data were analyzed using WINMIRA and SPSS 20.0 software.

RESULTS

Two latent classes were identified based on exercise knowledge among pregnant women. The Accurate Knowledge group (n = 543, 87.9%), which had a higher latent trait for exercise knowledge (M = 1.31, SD = 0.94), was larger than the Limited Knowledge group (n = 75, 12.1%), which had a lower latent trait (M = -0.22, SD = 1.14). The principles of exercise for pregnant women, particularly the appropriate intensity and duration, may be difficult items for women in the Limited Knowledge group to understand. Women with Limited Knowledge had significantly lower education levels and greater rates of unemployment, multiparity, and miscarriage than women in the Accurate Knowledge group.

LINKING EVIDENCE TO ACTION

A two-class system for interpreting exercise knowledge among pregnant women is statistically supported. We believe that this study has evidence-based potential to help healthcare providers improve pregnant women's exercise knowledge as part of routine prenatal care to promote exercise.

Item Analysis of Multiple Choice Questions at the Department of Paediatrics, Arabian Gulf University, Manama, Bahrain

Objectives

The current study aimed to carry out a post-validation item analysis of multiple choice questions (MCQs) in medical examinations in order to evaluate correlations between item difficulty, item discrimination and distraction effectiveness so as to determine whether questions should be included, modified or discarded. In addition, the optimal number of options per MCQ was analysed.

Methods

This cross-sectional study was performed in the Department of Paediatrics, Arabian Gulf University, Manama, Bahrain. A total of 800 MCQs and 4,000 distractors were analysed between November 2013 and June 2016.

Results

The mean difficulty index ranged from 36.70-73.14%. The mean discrimination index ranged from 0.20-0.34. The mean distractor efficiency ranged from 66.50-90.00%. Of the items, 48.4%, 35.3%, 11.4%, 3.9% and 1.1% had zero, one, two, three and four nonfunctional distractors (NFDs), respectively. Using three or four rather than five options in each MCQ resulted in 95% or 83.6% of items having zero NFDs, respectively. The distractor efficiency was 91.87%, 85.83% and 64.13% for difficult, acceptable and easy items, respectively (P <0.005). Distractor efficiency was 83.33%, 83.24% and 77.56% for items with excellent, acceptable and poor discrimination, respectively (P <0.005). The average Kuder-Richardson formula 20 reliability coefficient was 0.76.

Conclusion

A considerable number of the MCQ items were within acceptable ranges. However, some items needed to be discarded or revised. Using three or four rather than five options in MCQs is recommended to reduce the number of NFDs and improve the overall quality of the examination.