Celebrate Summer… by Writing Items

The sound of waves crashing at the beach, the feel of warm sand under your feet, the smell of sunscreen, the vision of colorful flowers everywhere, the taste of anything off of the grill…and the completion of item writing assignments – this is summer! The 2019–2020 item writing cycle is well underway with just one month to go. This is a good opportunity for us to provide some reminders about process and resources.

Last year, we shared six steps to approach the item writing process. One of the most critical components is planning. Using your item writing assignment, you can map your items to content area, task area, and diagnosis. For End of Curriculum™ Exam Development Board members, please remember that this year you have more detailed assignments that include Bloom’s Taxonomy level, setting, and lifespan. This planning on the front-end saves time and brainpower when the actual writing begins.

As you are writing your items, please make sure to reference the form and style guidelines. These were updated earlier this year to include a better organization strategy and greater detail regarding vignette format, which includes vital signs. The utilization of a comprehensive vignette requires the student to consider all aspects of a scenario (even if that means determining if the vital signs are normal or abnormal), similar to what they need to do with a real patient. This provides for a better assessment of students.

• Sentence 1:
  • Patient age
  • Gender
  • Site of care
  • Presenting symptom
  • Duration of symptom
• Sentence 2: Personal medical/surgical history
• Sentence 3: Family medical history
• Sentence 4: Social history (e.g., current history of smoking, drinking, drug use, sexual history)
• Sentence 5: Height/weight/body mass index, formatted as:
  • Height is XXX cm (XX in), weight is XX.X kg (XXX lbs), and body mass index is XX.X kg/m2.
• Sentence 6: Vital signs
  • Temperature is XX.X°C (XX.X°F), pulse rate is XXX/min and regular/irregular, respirations are XX/min and labored/unlabored, and blood pressure is XX/XX mmHg.

• Use your best discretion on the sentence breaks in relevant findings:
  • Physical examination findings
  • Laboratory findings
  • Urinalysis findings
  • Imaging study results

These components are then followed by the lead-in question.

Time invested during the initial item writing stage saves critical time during small-group peer- review and subsequent large-group review. Attention to item writing assignments and form and style guidelines assists everyone by having the highest quality of items from the beginning of the process.

If you have already started your item writing, reflect on these areas as you work to finish your assignment. If you have not yet started, now is the time. Find that special spot – in the office, at your dining room table, in the backyard, or at the beach – and become inspired to complete your assignment, with moments of summer to spare.

If you need ideas, get stuck on a specific task and content area combination, or would like someone to review a few items before you click submit, just reach out to your chair or to me. We would be happy to schedule a call with you to assist in whatever way we can.