J Educ Eval Health Prof.  2015;12:11. 10.3352/jeehp.2015.12.11.

Best fit model of exploratory and confirmatory factor analysis to the 2010 Medical Council of Canada's Qualifying Examination Part I clinical decision making cases

• De Champlain AF

• KMID: 2402018
• DOI: http://doi.org/10.3352/jeehp.2015.12.11

Abstract

PURPOSE
This study aims to assess the fit of a number of exploratory and confirmatory factor analysis models to the 2010 Medical Council of Canada's Qualifying Examination Part I (MCCQE1) clinical decision making cases (CDM). The outcomes of this study have important implications for a number of activities, including scoring and test development.
METHODS
Candidates included all first-time Canadian medical graduates and international Medical graduates who completed either the spring or fall 2010 test form of the MCCQE1. The fit of one- to five-factor exploratory models was assessed for the 2010 CDM cases item response matrix. Five confirmatory factor analytic models were also examined with the same CDM response matrix. The structural equation modeling software program, Mplus(R) was used for all analyses.
RESULTS
Out of five exploratory factor analytic models, a three-factor model provided the best fit. Factor 1 loaded on 3 medicine cases, 2 obstetrics and gynecology cases, and 2 orthopedic surgery cases. Factor 2 corresponded to a pediatrics factor whereas the third factor loads on psychiatry CDM cases. Among the five confirmatory factor analysis models examined in this study, three- and four-factor lifespan period models and the five factor discipline models provided the best fit.
CONCLUSION
Above results suggest that broad discipline domains best account for performance on CDM cases. In test development, particular effort should be placed on developing CDM cases according to broad discipline and patient age domains; CDM testlets should be assembled largely using these two constraints i.e. discipline and age.

Keyword

Educational measurement; Medical licensure; Statistical factor analysis, Canada

MeSH Terms

Decision Making*
Educational Measurement
Factor Analysis, Statistical*
Gynecology
Humans
Licensure, Medical
Obstetrics
Orthopedics
Pediatrics

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