We use the borderline regression method of calculating results. Each station has between three and six objectives which candidates are marked against. The examiner will give each candidate a mark between 0 and 4 for each objective. In addition to this the examiner will give a mark between 0 and 5 for the candidate’s overall performance.
The total possible mark for a station is 400. Objectives do not contribute equally to this score: some are more important than others. Each objective is given a percentage weighting depending on how important it is to the task the candidate is trying to complete. For example, a communication station might have four objectives: making a diagnosis, explaining the diagnosis to the patient, choosing an appropriate management plan for that patient and communicating the plan in a professional manner. Because the station focuses on communication the explaining and communicating objectives both contribute 40% of the mark, while the diagnosis and management objectives only contribute 10% each.
The examiner does not know the weightings for the objectives. This compensates for any conscious or unconscious bias the examiner may have.
When the results are processed we multiply the score the examiner gave by the weighting for that objective. So in the example above, if the candidate scored 3 on every objective, the weighted score would be 120 for each of the communication objectives and 30 for the other objectives. This gives a total score of 300 out of 400.
To calculate the pass mark for the station we look at the scores for every candidate who has ever taken that station. We compare the mean station score with the midpoint of the overall grade (0-5) given by the examiners. Plotted on a graph it would look like this:
The point where the two lines meet is the pass mark for the station. This means that the pass mark is set using the average ability of entry-level optometrists as well as examiner judgment.
Borderline regression is a method of standard setting that is used by medical professionals all over the world. It is considered to be the most objective way of setting the standard for practical exams such as OSCEs and is recognised internationally.