Abstract
BACKGROUND: In graduate medical education, assessment results can effectively guide professional development when both assessment and feedback support a formative model. When individuals cannot directly access the test questions and responses, a way of using assessment results formatively is to provide item keyword feedback. OBJECTIVE: The purpose of the following study was to investigate whether exposure to item keyword feedback aids in learner remediation. METHODS: Participants included 319 trainees who completed a medical subspecialty in-training examination (ITE) in 2012 as first-year fellows, and then 1 year later in 2013 as second-year fellows. Performance on 2013 ITE items in which keywords were, or were not, exposed as part of the 2012 ITE score feedback was compared across groups based on the amount of time studying (preparation). For the same items common to both 2012 and 2013 ITEs, response patterns were analyzed to investigate changes in answer selection. RESULTS: Test takers who indicated greater amounts of preparation on the 2013 ITE did not perform better on the items in which keywords were exposed compared to those who were not exposed. The response pattern analysis substantiated overall growth in performance from the 2012 ITE. For items with incorrect responses on both attempts, examinees selected the same option 58% of the time. CONCLUSIONS: Results from the current study were unsuccessful in supporting the use of item keywords in aiding remediation. Unfortunately, the results did provide evidence of examinees retaining misinformation.