A Practical Guide to Grade Adjustment or Curving for Pharmacy and Other Professional Health Programs.

The peer-reviewed literature on the adjustment or curving of assessments in health profession programs is almost non-existent. This communication aims to present potential methods of grade adjustment for individual questions or entire assessments. Simulated data for a 25-item assessment were used as an example to analyze the effects of different methods of grade adjustment on students' scores. Grade adjustments were made by adjusting the points for individual questions or the scores for the entire assessment. Adjustment for the individual questions was carried out by dropping the question, adding points to those who missed the question, or adding a bonus point to all students. Grade adjustment methods for the entire assessment included adjusting the mean or mean plus distribution (i.e., standard deviation) of the assessment score. Different methods of grade adjustments or curving for individual questions or the entire assessment resulted in drastically different outcomes for individual students' scores. The justifications for selecting the appropriate method for adjustment of the individual scores are presented based on item analysis statistics. Curving or adjusting the score for the entire exam may be justified when there is a need for consistency in grade distribution among the assessments across the years or different sections of the course. Although methods for adjustment of grades are relatively easy to implement, instructors should have reasonable educational justification for deciding whether to adjust grades or which method to use.