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Reforms of the Korean Medical Licensing Examination regarding item development and performance evaluation.

ABSTRACT: PURPOSE: The Korean Medical Licensing Examination (KMLE) has undergone a variety of innovative reforms implemented by the National Health Personnel Licensing Examination Board (NHPLEB) in order to make it a competency-based test. The purpose of this article is to describe the ways in which the KMLE has been reformed and the effect of those innovations on medical education in Korea. METHODS: Changes in the KMLE were traced from 1994 to 2014 by reviewing the adoption of new policies by the NHPLEB and the relevant literature. RESULTS: The most important reforms that turned the examination into a competency-based test were the following: First, the subjects tested on the exam were revised; second, R-type items were introduced; third, the proportion of items involving problem-solving skills was increased; and fourth, a clinical skills test was introduced in addition to the written test. The literature shows that the above reforms have resulted in more rigorous licensure standards and have improved the educational environment of medical schools in Korea. CONCLUSION: The reforms of the KMLE have led to improvements in how the competency of examinees is evaluated, as well as improvements in the educational system in medical schools in Korea.

SUBMITTER: Yim MK

PROVIDER: S-EPMC4397843 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Reforms of the Korean Medical Licensing Examination regarding item development and performance evaluation.

Yim Mi Kyoung MK

Journal of educational evaluation for health professions 20150317

<h4>Purpose</h4>The Korean Medical Licensing Examination (KMLE) has undergone a variety of innovative reforms implemented by the National Health Personnel Licensing Examination Board (NHPLEB) in order to make it a competency-based test. The purpose of this article is to describe the ways in which the KMLE has been reformed and the effect of those innovations on medical education in Korea.<h4>Methods</h4>Changes in the KMLE were traced from 1994 to 2014 by reviewing the adoption of new policies b ...[more]

PMID: 25797057

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Project description:PurposeThe purpose of this study was to improve the quality of items on the Korean Nursing Licensing Examination by developing and evaluating case-based items that reflect integrated nursing knowledge.MethodsWe conducted a cross-sectional observational study to develop new case-based items. The methods for developing test items included expert workshops, brainstorming, and verification of content validity. After a mock examination of undergraduate nursing students using the newly developed case-based items, we evaluated the appropriateness of the items through classical test theory and item response theory.ResultsA total of 50 case-based items were developed for the mock examination, and content validity was evaluated. The question items integrated 34 discrete elements of integrated nursing knowledge. The mock examination was taken by 741 baccalaureate students in their fourth year of study at 13 universities. Their average score on the mock examination was 57.4, and the examination showed a reliability of 0.40. According to classical test theory, the average level of item difficulty of the items was 57.4% (80%-100% for 12 items; 60%-80% for 13 items; and less than 60% for 25 items). The mean discrimination index was 0.19, and was above 0.30 for 11 items and 0.20 to 0.29 for 15 items. According to item response theory, the item discrimination parameter (in the logistic model) was none for 10 items (0.00), very low for 20 items (0.01 to 0.34), low for 12 items (0.35 to 0.64), moderate for 6 items (0.65 to 1.34), high for 1 item (1.35 to 1.69), and very high for 1 item (above 1.70). The item difficulty was very easy for 24 items (below -2.0), easy for 8 items (-2.0 to -0.5), medium for 6 items (-0.5 to 0.5), hard for 3 items (0.5 to 2.0), and very hard for 9 items (2.0 or above). The goodness-of-fit test in terms of the 2-parameter item response model between the range of 2.0 to 0.5 revealed that 12 items had an ideal correct answer rate.ConclusionWe surmised that the low reliability of the mock examination was influenced by the timing of the test for the examinees and the inappropriate difficulty of the items. Our study suggested a methodology for the development of future case-based items for the Korean Nursing Licensing Examination.

Project description:Traditional Korean medicine (TKM) emphasizes individualized diagnosis and treatment. This uniqueness makes AI modeling difficult due to limited data and implicit processes. Large language models (LLMs) have demonstrated impressive medical inference, even without advanced training in medical texts. This study assessed the capabilities of GPT-4 in TKM, using the Korean National Licensing Examination for Korean Medicine Doctors (K-NLEKMD) as a benchmark. The K-NLEKMD, administered by a national organization, encompasses 12 major subjects in TKM. GPT-4 answered 340 questions from the 2022 K-NLEKMD. We optimized prompts with Chinese-term annotation, English translation for questions and instruction, exam-optimized instruction, and self-consistency. GPT-4 with optimized prompts achieved 66.18% accuracy, surpassing both the examination's average pass mark of 60% and the 40% minimum for each subject. The gradual introduction of language-related prompts and prompting techniques enhanced the accuracy from 51.82% to its maximum accuracy. GPT-4 showed low accuracy in subjects including public health & medicine-related law, internal medicine (2), and acupuncture medicine which are highly localized in Korea and TKM. The model's accuracy was lower for questions requiring TKM-specialized knowledge than those that did not. It exhibited higher accuracy in diagnosis-based and recall-based questions than in intervention-based questions. A significant positive correlation was observed between the consistency and accuracy of GPT-4's responses. This study unveils both the potential and challenges of applying LLMs to TKM. These findings underline the potential of LLMs like GPT-4 in culturally adapted medicine, especially TKM, for tasks such as clinical assistance, medical education, and research. But they also point towards the necessity for the development of methods to mitigate cultural bias inherent in large language models and validate their efficacy in real-world clinical settings.

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Reforms of the Korean Medical Licensing Examination regarding item development and performance evaluation.

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Reforms of the Korean Medical Licensing Examination regarding item development and performance evaluation.

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