How well is each learner learning? Validity investigation of a learning curve-based assessment approach for ECG interpretation

Advances in Health Sciences Education : Theory and Practice
Rose HatalaMartin V Pusic

Abstract

Learning curves can support a competency-based approach to assessment for learning. When interpreting repeated assessment data displayed as learning curves, a key assessment question is: "How well is each learner learning?" We outline the validity argument and investigation relevant to this question, for a computer-based repeated assessment of competence in electrocardiogram (ECG) interpretation. We developed an on-line ECG learning program based on 292 anonymized ECGs collected from an electronic patient database. After diagnosing each ECG, participants received feedback including the computer interpretation, cardiologist's annotation, and correct diagnosis. In 2015, participants from a single institution, across a range of ECG skill levels, diagnosed at least 60 ECGs. We planned, collected and evaluated validity evidence under each inference of Kane's validity framework. For Scoring, three cardiologists' kappa for agreement on correct diagnosis was 0.92. There was a range of ECG difficulty across and within each diagnostic category. For Generalization, appropriate sampling was reflected in the inclusion of a typical clinical base rate of 39% normal ECGs. Applying generalizability theory presented unique challenges. Under the ...Continue Reading

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Citations

Dec 5, 2020·BMC Medical Education·Charle André ViljoenVanessa Celeste Burch
Oct 16, 2020·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Kathleen AdelgaisKathy Boutis
Aug 19, 2021·Academic Medicine : Journal of the Association of American Medical Colleges·Hannah L AndersonDaniel C West

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