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 Fifth Meeting of the IIME Core Committee
School-Level Standards Setting
March 10-12, 2004

New York City
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Once these student-level standards were established, it became possible to establish "cut scores" for individual institutions. This was done by identifying the percentage of students above or below standard at each school for each domain and examination type. Rather than create an arbitrary percentage of passing students that would constitute adequate performance on the part of a school, the IIME Core Committee was re-convened to consider this issue. After reviewing the examination materials and the student-level cut-scores, using an Angoff-like process, the Committee identified the acceptable percentage of students below cut-score at a competent school. This was done initially without reference to the Chinese data. After reviewing the performance data, the Committee was then allowed to adjust the acceptable failure rate. These allowable failure rates ranged from 9% to 24%.

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Applying these allowable failure rates to the aggregate performance of students on a school-by-school basis, it was possible to define areas of strength, borderline performance, and areas in need of improvement. It is worthwhile to note that the use of aggregated student performance data to determine school competence has never been done before and as such, this project will also break new ground in the area of school-level performance assessment.
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This project is, necessarily, the first step in validating the concept of global outcome standards for the profession. With further administration of this assessment prototype in other countries, aggregate performance of students from different countries may provide better international performance data for future standard setting procedures. Ultimately, validation of the international standard depends upon collecting at least one more set of data from China, and also data from students in other countries. It should be also re-emphasized that the Global Minimum Essential Requirements are not intended to describe the complete competencies of medical graduate in any country. These competencies represent, at best, 60% of what constitutes competency for practice in any one location because of reasonable differences in local, regional, and national healthcare expectations and practices.

  Institute for International Medical Education.
Unauthorized reproduction strictly prohibited.