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Thread warning: why the "psychometric validity" argument from the MCC is utter nonsense. 1/ https://twitter.com/giulianaguarna/status/1317135548851552258?s=19">https://twitter.com/giulianag...
Arguing that virtual exams would not be "psychometrically defensible" is analogous to arguing that if the CT scanner& #39;s down, and you have a patient with suspected PE, you should just wait a few weeks for the scanner to get fixed and leave the patient in limbo in the meantime. 2/
Let& #39;s break down the analogy
Patient = exam candidate
CT angio = traditional MCCQE 2
Other diagnostics (V/Q, US, D-dimer, etc) = best possible exam in a pandemic
Empiric treatment = waiving the exam
Leaving the patient in limbo = deferring the exam
3/
Patient = exam candidate
CT angio = traditional MCCQE 2
Other diagnostics (V/Q, US, D-dimer, etc) = best possible exam in a pandemic
Empiric treatment = waiving the exam
Leaving the patient in limbo = deferring the exam
3/
The point here is you can& #39;t just refuse to practice medicine when the CT is down. You have to do the best you can in the circumstances you& #39;re in. You might give anticoagulants to a few patients who don& #39;t actually have a PE. That& #39;s ok! 4/
What is *not* ok is privileging the sanctity of your carefully constructed diagnostic algorithm when the most important test isn& #39;t available to you. 5/
Medicine is real life. In crisis conditions, you sometimes have to do things differently from normal. Everyone understands that.
The same is true of assessment. It& #39;s not ok to just defer this determination indefinitely. 6/
The same is true of assessment. It& #39;s not ok to just defer this determination indefinitely. 6/
(Particularly because, by this analogy, the pretest probability of PE is about 99%, and the very need for the test is itself in doubt, but this is a digression.) 7/
Furthermore, the "psychometric defensibility" argument presupposes that the traditional MCCQE 2, relative to other possible assessments, has some special validity. 8/
I& #39;m no expert on psychometrics and validation, but the notion that there& #39;s some great reference standard against which to compare the MCCQE is just silly. (A bit like pulmonary angiography, come to think of it.) 9/
Yes, you can show that the MCCQE 2 correlates well with the CCFP or RCPSC exams, or with the absence of regulatory complaints, but this doesn& #39;t actually establish "validity" in any practical sense. 10/
And it certainly doesn& #39;t establish that the historical version of this test performs better than any other reasonable replacement test that might be used. 11/
