SETTING STANDARDS ON PERFORMANCE ASSESSMENTS OF PHYSICIANS CLINICAL SKILLS USING CONTRASTING GROUPS AND RECEIVER OPERATING CHARACTERISTIC CURVES

During recent years, the use of performance assessments for high-stake s evaluation of physicians' clinical skills has increased. As a result , considerable attention has been given to the identification of appro priate procedures for setting standards an performance assessments. Se veral articles have described application of the contrasting groups pr ocedure. It appears that the procedure is not well understood. Relativ ely little has been written about the requirements for using this proc edure appropriately. This article provides a discussion of the theoret ical framework for setting standards using contrasting groups. The dis cussion is then extended to include the circumstance in which the cont rasting groups data are interpreted using receiver operating character istic curves. Examples from the research literature involving variatio ns on the contrasting groups method for setting standards on performan ce assessments of clinical skills are discussed. The article concludes with guidelines for evaluators interested in using the contrasting gr oups procedure.