What is a Cut Score?

Eric Cheadle -

 A cut score is the mathematical probability that a student can pick the right answer rather than just guess correctly. Some might then interpret that as meaning the level of difficulty of a test question and that is kind of true in a broad sense. Though there is actually a different definition of difficulty when you look at a true test item analysis. So it is a reasonable way to remember things, in my opinion, but maybe a better way of thinking of it would be to consider it as how challenging it is to determine the best answer among the potential choices.

The Cut Score is determined by identifying the number of “good” distracters (wrong answers) among most often four plausible choices. In other words, the test writer is predicting statistically the likelihood that an uninformed person would pick the right answer.

The table below shows the method we choose to use to identify an individual item cut score. It is referred to as the Nedelsky model by our team.

# of good distracters - Item Cut score:
0 - .90 or 90%
1 - .60 or 60%
2 - .45 or 45%
3 -  .36 or 36%

Now let’s look at a scenario on how to apply this information in the real world.

Question 1
What is the best description of an incision?

  • A smooth cut made by a sharp object.
  • A wound that created a flap of skin
  • Incisions bleed more than lacerations.
  • Affect only the epidermis layer.

A is correct and none of the other answers are tempting to learners taking a test. The Cut Score is 0.90.

Question 2
Which of the following hemorrhage is best described as under pressure and squirts?

  • Carotid laceration
  • Deep cut of varicose vein
  • Abrasion affecting the capillaries
  • Rupture of blood vessels in the lining of the esophagus

A is correct and students find B, D very tempting when answering incorrectly. The Cut Score is 0.45.

Question 3
Choose the BEST description of professional conduct for a medical provider?

  • Actively participating in QI/CQI audits and meetings at their workplace
  • Staying late to talk with co-workers about interesting patient cases
  • Reading medical journals and research during vacation and off time.
  • Volunteering to provide first aid when needed at a public event.

A is correct while B, C, and D are very commonly picked wrong answers. The Cut Score is 0.36.


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