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The Objective Borderline method (OBM): a probability-based model for setting up an objective pass/fail cut-off score in medical programme assessments

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Abstract

The decision to pass or fail a medical student is a ‘high stakes’ one. The aim of this study is to introduce and demonstrate the feasibility and practicality of a new objective standard-setting method for determining the pass/fail cut-off score from borderline grades. Three methods for setting up pass/fail cut-off scores were compared: the Regression Method, the Borderline Group Method, and the new Objective Borderline Method (OBM). Using Year 5 students’ OSCE results from one medical school we established the pass/fail cut-off scores by the abovementioned three methods. The comparison indicated that the pass/fail cut-off scores generated by the OBM were similar to those generated by the more established methods (0.840 ≤ r ≤ 0.998; p < .0001). Based on theoretical and empirical analysis, we suggest that the OBM has advantages over existing methods in that it combines objectivity, realism, robust empirical basis and, no less importantly, is simple to use.

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Authors and Affiliations

  1. Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand

    Boaz Shulruf

  2. Department of Statistics, Faculty of Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand

    Rolf Turner

  3. Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand

    Phillippa Poole

  4. Health Care of the Elderly, University of Otago, The Princess Margaret Hospital, P.O. Box 800, Christchurch, New Zealand

    Tim Wilkinson

Authors
  1. Boaz Shulruf
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  2. Rolf Turner
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  3. Phillippa Poole
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  4. Tim Wilkinson
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Corresponding author

Correspondence to Boaz Shulruf.

Appendix 1: Practical instructions and an example

Appendix 1: Practical instructions and an example

How to use the OBM for setting up an objective pass/fail cut-off score.

The example below includes scores from OSCE station 1 used in the study. The borderline grades are defined as all scores between 6.75 and 7.25 inclusive, in total 12 scores.

The distribution of scores and classification for ‘Pass’ (P), ‘Borderline’ (B) and ‘Fail’ (F) is presented in Table 4. Overall there are 179 scores distributed as follow, where F, B, and P stand for the number of grades in each category:

Table 4 Example OSCE scores and grades (station 1)
Full size table

 

Number of fails (F)

F = 22

Number of borderlines (B)

B = 12

Number of passes (P)

P = 145

Use Eq. 1 to identify the score which will be used as the pass/fail cut-off.

Equation 1 the quantile determining the cut-off score

$$ 1 - \left( {\frac{\text{B}}{{ ( {\text{B + F)}}}}} \right)*\left( {\frac{\text{P}}{{ ( {\text{P + B)}}}}} \right) $$
(1)

Place F = 13, B = 12 and P = 145

$$ 1 - \left( {\frac{12}{(12 + 22)}} \right)*\left( {\frac{145}{(145 + 12)}} \right) = 0.674 = 67.4\,\% $$

The 67.4th percentile among the borderline scores determines the cut-off score.

Since there are 12 borderline (B) scores (see the shaded rows in Table 4), the cut-off score is the score above the 67.4 % of the borderline scores which is the 8.09th (12 × 0.674 = 8.09) or rounded up the 9th borderline score. In Table 4 we see that the 9th borderline score is 7.25 which is the minimum pass score for this OSCE examination for this population of examinees.

Note that six of the borderline grades have scores of 7.25 and it is impossible to rank them, hence everyone who achieved 7.25 or more will receive a pass grade in this station (similar to any other standard-setting method when a number of borderline scores could not be ranked).

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Shulruf, B., Turner, R., Poole, P. et al. The Objective Borderline method (OBM): a probability-based model for setting up an objective pass/fail cut-off score in medical programme assessments. Adv in Health Sci Educ 18, 231–244 (2013). https://doi.org/10.1007/s10459-012-9367-y

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