Dynamic cut-off scores in online nursing skills assessments? Borderline Regression Analysis

Introduction Skills examinations in nursing use a cut-off score of 40% to separate good and bad performing students. However, a fixed cut-off score is only associated with students ability to pass exams. The difficulty of the... [ view full abstract ]

Introduction
Skills examinations in nursing use a cut-off score of 40% to separate good and bad performing students. However, a fixed cut-off score is only associated with students ability to pass exams. The difficulty of the exam or variability between examiners in marking student’s performance is not being taken into account. The Online Marking Tool developed within NUIGs' College of Medicine, Nursing & Health Sciences incorporates various Global Rating Scales (GRS) marking professional competence as Pass, Borderline, Fail, Good and Excellent.
Material
Borderline Regression Analysis is used standard setting and determines a flexible cut-off score while the exam is ongoing. The Online Marking Tool contains of an OSCE Management Tool to plan and execute Objective Structured Clinical Examinations (OSCE), a OSCE station bank and a Result Analysis tool including a fully fledged Borderline Regression Analysis pack (Excel export pack). Individual (blinded) scores at item level are correlated with the GRS of Fail, Borderline, Pass, Good and Excellent or variations of this GRS (Borderline Fail and Borderline Pass; Fail, Borderline, Pass).
Results
Borderline Group Average, the average mean score of those students being marked as ‘Borderline’ is compared with Borderline Regression Method 1 and 2 (Borderline Fail e.g Pass) to determine a flexible cut-off score. Eighteen prestigious universities currently use this unique online marking tool for clinical skills assessments. Over 200 OSCE were successfully administered and analysed using this software solution.
Conclusion
More students fail after introducing Borderline Regression Analysis together with a minimum amount of stations that need to be passed. After introducing a flexible cut-off score difficulty of the task examined and difference between various examiners has been incorporated in the educational decision about pass or fail. After sharing this presentation you will know what Borderline Regression entails and how you could improve educational decision making at your institution.