Part III - National Board of Examiners in Optometry

Patient Care, 4/00 page 2be assessed. This allowed a broader sampling of clinical conditions, which elevated the contentvalidity of the test. By virtue of its greater simplicity, the PAM examination is more amenable tocomputerized testing than the combination of the former VRICS and PMP sections, and the latter inparticular.PAM is structured as a multiple-choice test. However, it can be regarded as an extended multiplechoicetest, as each item can contain as many as ten options, rather than being limited to five, andthe items are arranged in clusters. Each cluster consists of three multiple-choice items which arelinked to a patient’s case history presentation. The case history contains demographic data,personal and family ocular and overall health data, and clinical findings. For most case histories,some of the clinical findings are presented in visual form, simulating their appearance in a livepatient encounter.The items within a cluster focus on either a diagnosis or treatment issue. The first item presents themost critical item within the cluster: indicating either the correct diagnosis or the correct treatment.The two subsequent items measure any of a number of related or follow-up issues. Although theitems are related, the scoring protocol allows a candidate who selects and incorrect response for thefirst item to select the correct response to either or both of the follow-up items.The PAM items are differentially weighted for scoring (i.e., one or two points), rather than havingthe same scoring weight (i.e., one point only), as traditional multiple-choice items. The first item ineach cluster, as the most critical, is worth two points if answered correctly. Each of the two followupitems is worth one point.Each item cluster has a performance standard. The standard is based on allowing only one error percluster, so long as the error is on one of the follow-up items. As each cluster contains four points,the allowance of one non-critical error yields a performance standard of 75% (3 of 4 points) foreach cluster. Since a pass-fail cutoff score is the average of a test’s item performance standards, thepass-fail cutoff score on PAM is 75%. However, by National Board criteria, candidates do not passor fail individual sections; passing is based exclusively on the overall Part performance. Therefore,the PAM cutoff score is 75% is added to the cutoff score for CSE and then weighted such that thePAM cutoff accounts for 35% of the overall Part III pass-fail cutoff score. Candidates at or abovethis overall cutoff score pass, regardless of their profile of scores or subscores.The PAM examination was administered on April 3 in 16 test centers. The CSE was administeredduring three weekends at 16 sites, including, for the first time, San Juan, Puerto Rico. Theexamination was conducted by 505 examiners, with 44 states, the District of Columbia, and theCommonwealth of Puerto Rico participating. State-prepared law examinations were administeredon April 3.The number of candidates sitting for the examination was unprecedentedly high. Each of the priorSpring administrations hosted what was then a record high number of candidates. The populationof 1368 candidates sitting for the entire Part III examination in April 2000 continued this trend. Ofthe full Part III candidate population, three candidates received special accommodations under theAmericans with Disabilities Act; one for CSE only and two for PAM only.