Improving item pool utilization for health professions examinations under variable-length computerized adaptive testing designs: a shadow-test approach.

Purpose: The shadow-test approach to computerized adaptive testing (CAT) ensures content validity in health professions examinations but may suffer from poor item pool utilization in variable-length designs, increasing operational costs and security risks. This study aimed to address this challenge...

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Publicado en:Journal of Educational Evaluation for Health Professions Vol. 22; pp. 1 - 10
Autores principales: Lim, Hwanggyu, Han, Kyung (Chris) Tyek
Formato: equations & formulas pictorial research tables/charts Journal Article
Publicado: National Health Personnel Licensing Examination Board 2025
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Journal of Educational Evaluation for Health Professions
      issn: 19755937
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      dt: 2025
      vid: 22
      pid: 58691
      pub: National Health Personnel Licensing Examination Board
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        10.3352/jeehp.2025.22.35
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        atl: Improving item pool utilization for health professions examinations under variable-length computerized adaptive testing designs: a shadow-test approach.
      aug:
        au:
          Lim, Hwanggyu
          Han, Kyung (Chris) Tyek
        affil: College of Education, Inha University, Incheon, Korea
      sug:
        subj:
          Education, Health Sciences
          Computerized Adaptive Testing
          Algorithms
          Psychometrics
          Human
          Funding Source
          Female
          Male
          Descriptive Statistics
          Comparative Studies
          Conceptual Framework
          Health Occupations
          Computer Simulation
          Questionnaires
          Content Validity
          Chi Square Test
          Data Analysis Software
          Credentialing Examinations
          Licensure
          Models, Theoretical
          Female
          Male
      ab: Purpose: The shadow-test approach to computerized adaptive testing (CAT) ensures content validity in health professions examinations but may suffer from poor item pool utilization in variable-length designs, increasing operational costs and security risks. This study aimed to address this challenge by developing algorithms that enhance the sustainability of shadow CAT in variable-length design. Methods: A simulation study was conducted to evaluate 3 proposed modifications of the α-stratification method designed to improve item pool utilization. These methods, which integrated randomesque selection and multiple-form strategies, were compared with 2 baseline algorithms within a variable-length shadow CAT framework. Performance was assessed in terms of measurement precision, pool utilization, and test efficiency. Results: The proposed modifications significantly outperformed the baseline methods across all measures of item pool utilization and exposure control. The most effective method (Modification 2) reduced the proportion of unused items from 35.6% to 5.0% and produced more uniform item exposure rates. These substantial gains in operational sustainability were achieved while maintaining measurement precision comparable to the baseline methods. Conclusion: The proposed algorithms effectively mitigate poor item pool utilization in shadow CAT under variable-length design. This enhanced framework provides a robust, secure, and sustainable solution for high-stakes adaptive assessments in the health professions that remain content-valid, precise, and operationally efficient. INSET: 1.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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