Journal of Educational Evaluation for Health Professions

Research articles

Validity evaluation of a mock examination including multimedia-assisted items for the Korean Nursing Licensing Examination: a mixed-methods study with a counterbalanced design: Sujin Shin, Inyoung Lee, Heejeong Kim, Rhayun Song, Jun-Ah Song, Hyun Sook Yi, Janghee Park, Mi Kyoung Yim, Minjae Lee, Subin Yu; J Educ Eval Health Prof. 2026;23:21. Published online July 21, 2026; DOI: https://doi.org/10.3352/jeehp.2026.23.21 [Epub ahead of print]

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Abstract PDF: Purpose
This study aimed to evaluate the validity of multimedia-assisted items (MAIs) in a mock examination by examining their psychometric properties and nursing students’ perceptions.
Methods
This methodological study used a within-group counterbalanced design in which fourth-year nursing students in South Korea completed an online mock examination consisting of paired text-based items and MAIs. Psychometric properties were examined using classical test theory and item response theory, and learner perceptions and response processes were explored through post-examination surveys and focus group interviews.
Results
Among 515 participants, MAIs demonstrated overall difficulty and discrimination comparable to those of text-based items in both classical test theory and item response theory analyses, with similar test characteristic curves across counterbalanced groups, supporting measurement equivalence across item formats. Post-test surveys indicated that participants perceived MAIs as realistic reflections of clinical practice and as more helpful for problem solving and ability assessment than text-based items. Qualitative findings from focus group interviews (n=15) further supported the educational value of MAIs for assessing clinical judgment while emphasizing the need for appropriate multimedia use. An order effect was also observed: presenting MAIs first led to higher item response theory discrimination parameters in subsequent text-based items (P=0.020).
Conclusion
MAIs demonstrated psychometric properties comparable to those of text-based items and were positively perceived as valid tools for assessing clinical judgment and practical competence. These findings support the feasibility of incorporating multimedia-based assessment into the Korean Nursing Licensing Examination as part of a rigorous computer-based testing framework.

Proposal for setting a passing score for the Korean Nursing Licensing Examination: Janghee Park, Mi Kyoung Yim, Sujin Shin, Rhayun Song, Jun-Ah Song, Inyoung Lee, Heejeong Kim, Minjae Lee; J Educ Eval Health Prof. 2025;22:25. Published online September 8, 2025; DOI: https://doi.org/10.3352/jeehp.2025.22.25

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Abstract PDF Supplementary Material: Purpose
The Korean Nursing Licensing Examination (KNLE) is planning to transition to a computer-based test (CBT). This study aims to propose a reasonable and efficient method for setting passing scores.
Methods
A standard-setting (passing score setting) analysis was conducted using an expert panel over the past 3 years of the national nursing examination. The standard-setting method was modified from Angoff, and the validity of the passing score was verified through the Hofstee method. The standard-setting workshop was conducted in 2 stages: first, a pilot workshop for 2 subjects, followed by a second workshop where 6 additional subjects were selected based on the pilot results. For items with an actual correct answer rate of 90% or higher, the estimated correct answer rate for minimum competency was calculated using the observed correct answer rate. A survey and discussion with the expert panel were also conducted regarding the standard-setting procedures and results.
Results
The passing score for the national nursing examination was calculated using the new method, and the score was slightly higher than the existing score. The nursing subject had similar results; however, the legal subjects varied.
Conclusion
The modified Angoff and Hofstee methods were successfully applied to the KNLE. Using the actual correct answer rate as an indicator to derive expected minimum competency was shown to be effective. This approach could streamline future standard-setting processes, particularly when converting to CBT.

Medical students’ patterns of using ChatGPT as a feedback tool and perceptions of ChatGPT in a Leadership and Communication course in Korea: a cross-sectional study: Janghee Park; J Educ Eval Health Prof. 2023;20:29. Published online November 10, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.29

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Abstract PDF Supplementary Material

Purpose
This study aimed to analyze patterns of using ChatGPT before and after group activities and to explore medical students’ perceptions of ChatGPT as a feedback tool in the classroom.
Methods
The study included 99 2nd-year pre-medical students who participated in a “Leadership and Communication” course from March to June 2023. Students engaged in both individual and group activities related to negotiation strategies. ChatGPT was used to provide feedback on their solutions. A survey was administered to assess students’ perceptions of ChatGPT’s feedback, its use in the classroom, and the strengths and challenges of ChatGPT from May 17 to 19, 2023.
Results
The students responded by indicating that ChatGPT’s feedback was helpful, and revised and resubmitted their group answers in various ways after receiving feedback. The majority of respondents expressed agreement with the use of ChatGPT during class. The most common response concerning the appropriate context of using ChatGPT’s feedback was “after the first round of discussion, for revisions.” There was a significant difference in satisfaction with ChatGPT’s feedback, including correctness, usefulness, and ethics, depending on whether or not ChatGPT was used during class, but there was no significant difference according to gender or whether students had previous experience with ChatGPT. The strongest advantages were “providing answers to questions” and “summarizing information,” and the worst disadvantage was “producing information without supporting evidence.”
Conclusion
The students were aware of the advantages and disadvantages of ChatGPT, and they had a positive attitude toward using ChatGPT in the classroom.

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Information amount, accuracy, and relevance of generative artificial intelligence platforms’ answers regarding learning objectives of medical arthropodology evaluated in English and Korean queries in December 2023: a descriptive study
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Evaluation of medical school faculty members’ educational performance in Korea in 2022 through analysis of the promotion regulations: a mixed methods study: Hye Won Jang, Janghee Park; J Educ Eval Health Prof. 2023;20:7. Published online February 28, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.7

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Abstract PDF Supplementary Material

Purpose
To ensure faculty members’ active participation in education in response to growing demand, medical schools should clearly describe educational activities in their promotion regulations. This study analyzed the status of how medical education activities are evaluated in promotion regulations in 2022, in Korea.
Methods
Data were collected from promotion regulations retrieved by searching the websites of 22 medical schools/universities in August 2022. To categorize educational activities and evaluation methods, the Association of American Medical Colleges framework for educational activities was utilized. Correlations between medical schools’ characteristics and the evaluation of medical educational activities were analyzed.
Results
We defined 6 categories, including teaching, development of education products, education administration and service, scholarship in education, student affairs, and others, and 20 activities with 57 sub-activities. The average number of included activities was highest in the development of education products category and lowest in the scholarship in education category. The weight adjustment factors of medical educational activities were the characteristics of the target subjects and faculty members, the number of involved faculty members, and the difficulty of activities. Private medical schools tended to have more educational activities in the regulations than public medical schools. The greater the number of faculty members, the greater the number of educational activities in the education administration and service categories.
Conclusion
Medical schools included various medical education activities and their evaluation methods in promotion regulations in Korea. This study provides basic data for improving the rewarding system for efforts of medical faculty members in education.

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A proposal to address faculty recruitment challenges in regional medical schools: incorporating clinical performance into scholarly evaluation
Ji Young Lee, Heesung Song
Journal of Medicine and Life Science.2026; 23(2): 93. CrossRef

Possibility of using the yes/no Angoff method as a substitute for the percent Angoff method for estimating the cutoff score of the Korean Medical Licensing Examination: a simulation study: Janghee Park; J Educ Eval Health Prof. 2022;19:23. Published online August 31, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.23

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Abstract PDF Supplementary Material

Purpose
The percent Angoff (PA) method has been recommended as a reliable method to set the cutoff score instead of a fixed cut point of 60% in the Korean Medical Licensing Examination (KMLE). The yes/no Angoff (YNA) method, which is easy for panelists to judge, can be considered as an alternative because the KMLE has many items to evaluate. This study aimed to compare the cutoff score and the reliability depending on whether the PA or the YNA standard-setting method was used in the KMLE.
Methods
The materials were the open-access PA data of the KMLE. The PA data were converted to YNA data in 5 categories, in which the probabilities for a “yes” decision by panelists were 50%, 60%, 70%, 80%, and 90%. SPSS for descriptive analysis and G-string for generalizability theory were used to present the results.
Results
The PA method and the YNA method counting 60% as “yes,” estimated similar cutoff scores. Those cutoff scores were deemed acceptable based on the results of the Hofstee method. The highest reliability coefficients estimated by the generalizability test were from the PA method and the YNA method, with probabilities of 70%, 80%, 60%, and 50% for deciding “yes,” in descending order. The panelist’s specialty was the main cause of the error variance. The error size was similar regardless of the standard-setting method.
Conclusion
The above results showed that the PA method was more reliable than the YNA method in estimating the cutoff score of the KMLE. However, the YNA method with a 60% probability for deciding “yes” also can be used as a substitute for the PA method in estimating the cutoff score of the KMLE.

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Refining competency benchmarks: a scoping review of Angoff standard-setting in dental education
Galvin Sim Siang Lin, Abdul Rauf Badrul Hisham, Muhammad Nazmi Abdul Majid, Chan Choong Foong, Ting Khee Ho, Lara T. Friedlander
BMC Oral Health.2026;[Epub] CrossRef
Standard setting for dental knowledge tests: reproducibility of the modified Angoff and Ebel method across judges
Ting Khee Ho, Noor Lide Abu Kassim, Lucy O’Malley, Reza Vahid Roudsari
BMC Medical Education.2025;[Epub] CrossRef
Angoff methods in standard setting in health professional education: a systematic review and meta-analysis
Kannan Sridharan, Gowri Sivaramakrishnan
BMC Medical Education.2025;[Epub] CrossRef
Comparing the passing rates of nursing students participating in the objective structured clinical examination using fixed score, Angoff, yes/no Angoff, and 3-level Angoff methods†
Fatemeh Maghsoodi, Mohammadreza Yazdankhahfard, Shahnaz Pouladi, Kamran Mirzaei, Amin Beigzadeh
Frontiers of Nursing.2025; 12(4): 511. CrossRef
Issues in the 3rd year of the COVID-19 pandemic, including computer-based testing, study design, ChatGPT, journal metrics, and appreciation to reviewers
Sun Huh
Journal of Educational Evaluation for Health Professions.2023; 20: 5. CrossRef
Possibility of independent use of the yes/no Angoff and Hofstee methods for the standard setting of the Korean Medical Licensing Examination written test: a descriptive study
Do-Hwan Kim, Ye Ji Kang, Hoon-Ki Park
Journal of Educational Evaluation for Health Professions.2022; 19: 33. CrossRef

Similarity of the cut score in test sets with different item amounts using the modified Angoff, modified Ebel, and Hofstee standard-setting methods for the Korean Medical Licensing Examination: Janghee Park, Mi Kyoung Yim, Na Jin Kim, Duck Sun Ahn, Young-Min Kim; J Educ Eval Health Prof. 2020;17:28. Published online October 5, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.28

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225 Download
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Abstract PDF Supplementary Material

Purpose
The Korea Medical Licensing Exam (KMLE) typically contains a large number of items. The purpose of this study was to investigate whether there is a difference in the cut score between evaluating all items of the exam and evaluating only some items when conducting standard-setting.
Methods
We divided the item sets that appeared on 3 recent KMLEs for the past 3 years into 4 subsets of each year of 25% each based on their item content categories, discrimination index, and difficulty index. The entire panel of 15 members assessed all the items (360 items, 100%) of the year 2017. In split-half set 1, each item set contained 184 (51%) items of year 2018 and each set from split-half set 2 contained 182 (51%) items of the year 2019 using the same method. We used the modified Angoff, modified Ebel, and Hofstee methods in the standard-setting process.
Results
Less than a 1% cut score difference was observed when the same method was used to stratify item subsets containing 25%, 51%, or 100% of the entire set. When rating fewer items, higher rater reliability was observed.
Conclusion
When the entire item set was divided into equivalent subsets, assessing the exam using a portion of the item set (90 out of 360 items) yielded similar cut scores to those derived using the entire item set. There was a higher correlation between panelists’ individual assessments and the overall assessments.

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Standard setting for dental knowledge tests: reproducibility of the modified Angoff and Ebel method across judges
Ting Khee Ho, Noor Lide Abu Kassim, Lucy O’Malley, Reza Vahid Roudsari
BMC Medical Education.2025;[Epub] CrossRef
Angoff methods in standard setting in health professional education: a systematic review and meta-analysis
Kannan Sridharan, Gowri Sivaramakrishnan
BMC Medical Education.2025;[Epub] CrossRef
Application of computer-based testing in the Korean Medical Licensing Examination, the emergence of the metaverse in medical education, journal metrics and statistics, and appreciation to reviewers and volunteers
Sun Huh
Journal of Educational Evaluation for Health Professions.2022; 19: 2. CrossRef
Possibility of using the yes/no Angoff method as a substitute for the percent Angoff method for estimating the cutoff score of the Korean Medical Licensing Examination: a simulation study
Janghee Park
Journal of Educational Evaluation for Health Professions.2022; 19: 23. CrossRef
Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study
Ying-Ying Yang, Pin-Hsiang Huang, Ling-Yu Yang, Chia-Chang Huang, Chih-Wei Liu, Shiau-Shian Huang, Chen-Huan Chen, Fa-Yauh Lee, Shou-Yen Kao, Boaz Shulruf
Journal of Educational Evaluation for Health Professions.2022; 19: 27. CrossRef
Possibility of independent use of the yes/no Angoff and Hofstee methods for the standard setting of the Korean Medical Licensing Examination written test: a descriptive study
Do-Hwan Kim, Ye Ji Kang, Hoon-Ki Park
Journal of Educational Evaluation for Health Professions.2022; 19: 33. CrossRef
Presidential address: Quarantine guidelines to protect examinees from coronavirus disease 2019, clinical skills examination for dental licensing, and computer-based testing for medical, dental, and oriental medicine licensing
Yoon-Seong Lee
Journal of Educational Evaluation for Health Professions.2021; 18: 1. CrossRef
Comparing the cut score for the borderline group method and borderline regression method with norm-referenced standard setting in an objective structured clinical examination in medical school in Korea
Song Yi Park, Sang-Hwa Lee, Min-Jeong Kim, Ki-Hwan Ji, Ji Ho Ryu
Journal of Educational Evaluation for Health Professions.2021; 18: 25. CrossRef

Comparison of standard-setting methods for the Korean Radiological Technologist Licensing Examination: Angoff, Ebel, bookmark, and Hofstee: Janghee Park, Duck-Sun Ahn, Mi Kyoung Yim, Jaehyoung Lee; J Educ Eval Health Prof. 2018;15:32. Published online December 26, 2018; DOI: https://doi.org/10.3352/jeehp.2018.15.32

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Abstract PDF Supplementary Material

Purpose
This study aimed to compare the possible standard-setting methods for the Korean Radiological Technologist Licensing Examination, which has a fixed cut score, and to suggest the most appropriate method.
Methods
Six radiological technology professors set standards for 250 items on the Korean Radiological Technologist Licensing Examination administered in December 2016 using the Angoff, Ebel, bookmark, and Hofstee methods.
Results
With a maximum percentile score of 100, the cut score for the examination was 71.27 using the Angoff method, 62.2 using the Ebel method, 64.49 using the bookmark method, and 62 using the Hofstee method. Based on the Hofstee method, an acceptable cut score for the examination would be between 52.83 and 70, but the cut score was 71.27 using the Angoff method.
Conclusion
The above results suggest that the best standard-setting method to determine the cut score would be a panel discussion with the modified Angoff or Ebel method, with verification of the rated results by the Hofstee method. Since no standard-setting method has yet been adopted for the Korean Radiological Technologist Licensing Examination, this study will be able to provide practical guidance for introducing a standard-setting process.

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Standard setting for dental knowledge tests: reproducibility of the modified Angoff and Ebel method across judges
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Angoff methods in standard setting in health professional education: a systematic review and meta-analysis
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Possibility of independent use of the yes/no Angoff and Hofstee methods for the standard setting of the Korean Medical Licensing Examination written test: a descriptive study
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Comparison of the validity of bookmark and Angoff standard setting methods in medical performance tests
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Comparing the cut score for the borderline group method and borderline regression method with norm-referenced standard setting in an objective structured clinical examination in medical school in Korea
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Similarity of the cut score in test sets with different item amounts using the modified Angoff, modified Ebel, and Hofstee standard-setting methods for the Korean Medical Licensing Examination
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Brief Report

Proposal for a Modified Dreyfus and Miller Model with simplified competency level descriptions for performing self-rated surveys: Janghee Park; J Educ Eval Health Prof. 2015;12:54. Published online November 30, 2015; DOI: https://doi.org/10.3352/jeehp.2015.12.54

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Abstract PDF

In competency-based education, it is important to frequently evaluate the degree of competency achieved by establishing and specifying competency levels. To self-appraise one’s own competency level, one needs a simple, clear, and accurate description for each competency level. This study aimed at developing competency stages that can be used in surveys and conceptualizing clear and precise competency level descriptions. In this paper, the author intends to conceptualize a simple competency level description through a literature review. The author modified the most widely quoted competency level models—Dreyfus’ Five-stage Model and Miller’s Pyramid—and classified competency levels into the following: The Modified Dreyfus Model comprises absolute beginner, beginner, advanced beginner, competent, proficient, and expert, while the Modified Miller Model uses the levels of knows little, knows and knows how, exercised does, selected does, experienced does, and intuitive does. The author also provided a simple and clear description of competency levels. The precise description of competency levels developed in this study is expected to be useful in determining one’s competency level in surveys.

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