Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, School of Health Professions Education (SHE), Maastricht University, Postbus 616, 6200, Maastricht, The Netherlands.
European Board of Medical Assessors, Edinburgh, UK.
Adv Health Sci Educ Theory Pract. 2022 May;27(2):427-440. doi: 10.1007/s10459-022-10093-y. Epub 2022 Feb 24.
Criticisms about psychometric paradigms currently used in healthcare professions education include claims of reductionism, objectification, and poor compliance with assumptions. Nevertheless, perhaps the most crucial criticism comes from learners' difficulty in interpreting and making meaningful use of summative scores and the potentially detrimental impact these scores have on learners. The term "post-psychometric era" has become popular, despite persisting calls for the sensible use of modern psychometrics. In recent years, cognitive diagnostic modelling has emerged as a new psychometric paradigm capable of providing meaningful diagnostic feedback. Cognitive diagnostic modelling allows the classification of examinees in multiple cognitive attributes. This measurement is obtained by modelling these attributes as categorical, discrete latent variables. Furthermore, items can reflect more than one latent variable simultaneously. The interactions between latent variables can be modelled with flexibility, allowing a unique perspective on complex cognitive processes. These characteristic features of cognitive diagnostic modelling enable diagnostic classification over a large number of constructs of interest, preventing the necessity of providing numerical scores as feedback to test takers. This paper provides an overview of cognitive diagnostic modelling, including an introduction to its foundations and illustrating potential applications, to help teachers be involved in developing and evaluating assessment tools used in healthcare professions education. Cognitive diagnosis may represent a revolutionary new psychometric paradigm, overcoming the known limitations found in frequently used psychometric approaches, offering the possibility of robust qualitative feedback and better alignment with competency-based curricula and modern programmatic assessment frameworks.
目前在医疗保健专业教育中使用的心理计量范式受到了批评，包括声称其具有简化论、客观主义以及与假设不符等问题。然而，也许最关键的批评来自学习者难以解释和有效地利用总结性分数，以及这些分数可能对学习者产生的潜在不利影响。尽管人们一直呼吁明智地使用现代心理计量学，但“后心理计量时代”这个术语还是变得流行起来。近年来，认知诊断建模作为一种新的心理计量范式出现，能够提供有意义的诊断反馈。认知诊断建模允许将考生分类为多个认知属性。这种测量是通过将这些属性建模为分类的、离散的潜在变量来实现的。此外，项目可以同时反映多个潜在变量。潜在变量之间的相互作用可以灵活建模，从而可以从独特的角度看待复杂的认知过程。认知诊断建模的这些特征功能可以在大量感兴趣的结构上进行诊断分类，从而避免了向考生提供数字分数作为反馈的必要性。本文概述了认知诊断建模，包括其基础介绍和潜在应用举例，以帮助教师参与开发和评估医疗保健专业教育中使用的评估工具。认知诊断可能代表了一种革命性的新心理计量范式，可以克服经常使用的心理计量方法中存在的已知局限性，提供强有力的定性反馈，并更好地与基于能力的课程和现代项目评估框架保持一致。
