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13. Detection of Learning in Longitudinal Assessment via Score-Based Tests

Author

Wang, Tim, Sun, Huaping, Zhou, Yan, and Harman, Ann E.

Abstract

Longitudinal assessment is a type of assessment involving repeated measures over a period to evaluate whether and when an attribute (e.g., ability, skill) changes. Thus, change detection is of central interest in longitudinal assessment. In the assessment setting, change in the desired direction (typically upward) is often referred to as "learning". While many methods have been proposed to detect change, they all require a prior definition of a changing point. However, this information is often unknown in practice. As an alternative, we focus on a family of tests based on stochastic processes of case-wise derivatives of the likelihood function (i.e., scores). These score-based tests could detect "learning" without prior information of a changing point and signal the changing point to the users. In this article, we will illustrate what the score-based tests are and the novel application by using the data of two physicians participating in longitudinal assessment for a medical specialty certifying board's continuous certification program.

Published
2020

27. Option to survive or surrender: carbon asset management and optimization in thermal power enterprises from China

Author

Liu, Yue, Tian, Lixin, Xie, Zhuyun, Zhen, Zaili, and Sun, Huaping

Subjects
Economics - General Economics
Abstract

Carbon emission right allowance is a double-edged sword, one edge is to reduce emission as its original design intention, another edge has in practice slain many less developed coal-consuming enterprises, especially for those in thermal power industry. Partially governed on the hilt in hands of the authority, body of this sword is the prices of carbon emission right. How should the thermal power plants dance on the blade motivates this research. Considering the impact of price fluctuations of carbon emission right allowance, we investigate the operation of Chinese thermal power plant by modeling the decision-making with optimal stopping problem, which is established on the stochastic environment with carbon emission allowance price process simulated by geometric Brownian motion. Under the overall goal of maximizing the ultimate profitability, the optimal stopping indicates the timing of suspend or halt of production, hence the optimal stopping boundary curve implies the edge of life and death with regard to this enterprise. Applying this methodology, real cases of failure and survival of several Chinese representative thermal power plants were analyzed to explore the industry ecotope, which leads to the findings that: 1) The survival environment of existed thermal power plants becomes severer when facing more pressure from the newborn carbon-finance market. 2) Boundaries of survival environment is mainly drawn by the technical improvements for rising the utilization rate of carbon emission. Based on the same optimal stopping model, outlook of this industry is drawn with a demarcation surface defining the vivosphere of thermal power plants with different levels of profitability. This finding provides benchmarks for those enterprises struggling for survival and policy makers scheming better supervision and necessary intervene.

Published
2021

40. First-Year Results of the American Board of Anesthesiology's Objective Structured Clinical Examination for Initial Certification.

Author

Warner, David O, Lien, Cynthia A, Wang, Ting, Zhou, Yan, Isaak, Robert S, Peterson-Layne, Cathleen, Harman, Ann E, Macario, Alex, Gaiser, Robert R, Suresh, Santhanam, Culley, Deborah J, Rathmell, James P, Keegan, Mark T, Cole, Daniel J, Fahy, Brenda G, Dainer, Rupa J, and Sun, Huaping

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Clinical Research, Anesthesiology, Certification, Clinical Competence, Communication, Educational Measurement, Humans, Internship and Residency, Learning, Professional Role, Quality Improvement, Specialty Boards, Ultrasonography, United States, Clinical Sciences, Neurosciences, Clinical sciences
Abstract

In 2018, the American Board of Anesthesiology (ABA) became the first US medical specialty certifying board to incorporate an Objective Structured Clinical Examination (OSCE) into its initial certification examination system. Previously, the ABA's staged examination system consisted of 2 written examinations (the BASIC and ADVANCED examinations) and the Standardized Oral Examination (SOE). The OSCE and the existing SOE are now 2 separate components of the APPLIED Examination. This report presents the results of the first-year OSCE administration. A total of 1410 candidates took both the OSCE and the SOE in 2018. Candidate performance approximated a normal distribution for both the OSCE and the SOE, and was not associated with the timing of the examination, including day of the week, morning versus afternoon session, and order of the OSCE and the SOE. Practice-based Learning and Improvement was the most difficult station, while Application of Ultrasonography was the least difficult. The correlation coefficient between SOE and OSCE scores was 0.35 ([95% confidence interval {CI}, 0.30-0.39]; P < .001). Scores for the written ADVANCED Examination were modestly correlated with scores for the SOE (r = 0.29 [95% CI, 0.25-0.34]; P < .001) and the OSCE (r = 0.15 [95% CI, 0.10-0.20]; P < .001). Most of the candidates who failed the SOE passed the OSCE, and most of the candidates who failed the OSCE passed the SOE. Of the 1410 candidates, 77 (5.5%) failed the OSCE, 155 (11.0%) failed the SOE, and 25 (1.8%) failed both. Thus, 207 (14.7%) failed at least 1 component of the APPLIED Examination. Adding an OSCE to a board certification examination system is feasible. Preliminary evidence indicates that the OSCE measures aspects of candidate abilities distinct from those measured by other examinations used for initial board certification.

Published
2020

43. Development of an Objective Structured Clinical Examination as a Component of Assessment for Initial Board Certification in Anesthesiology.

Author

Warner, David O, Isaak, Robert S, Peterson-Layne, Cathleen, Lien, Cynthia A, Sun, Huaping, Menzies, Anna O, Cole, Daniel J, Dainer, Rupa J, Fahy, Brenda G, Macario, Alex, Suresh, Santhanam, and Harman, Ann E

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Anesthesiologists, Anesthesiology, Clinical Competence, Curriculum, Education, Medical, Graduate, Educational Measurement, Educational Status, Humans, Specialty Boards, Clinical Sciences, Neurosciences, Clinical sciences
Abstract

With its first administration of an Objective Structured Clinical Examination (OSCE) in 2018, the American Board of Anesthesiology (ABA) became the first US medical specialty certifying board to incorporate this type of assessment into its high-stakes certification examination system. The fundamental rationale for the ABA's introduction of the OSCE is to include an assessment that allows candidates for board certification to demonstrate what they actually "do" in domains relevant to clinical practice. Inherent in this rationale is that the OSCE will capture competencies not well assessed in the current written and oral examinations-competencies that will allow the ABA to judge whether a candidate meets the standards expected for board certification more properly. This special article describes the ABA's journey from initial conceptualization through first administration of the OSCE, including the format of the OSCE, the process for scenario development, the standardized patient program that supports OSCE administration, examiner training, scoring, and future assessment of reliability, validity, and impact of the OSCE. This information will be beneficial to both those involved in the initial certification process, such as residency graduate candidates and program directors, and others contemplating the use of high-stakes summative OSCE assessments.

Published
2020

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