Comparison of results between modified-Angoff and bookmark methods for estimating cut score of the Korean medical licensing examination

PURPOSE: The purpose of this study was to apply alternative standard setting methods for the Korean Medical Licensing Examination (KMLE), a criterion-referenced written examination, and to compare them to the conventional cut score used on the KMLE. METHODS: The process and results of criterion-referenced standard settings (i.e., the modified-Angoff and bookmark methods) were evaluated. The ratio of passing and failing examinees determined using these alternative standard setting methods was compared to the results of the conventional criteria. Additionally, the external, internal and procedural evaluation of these methods were reviewed. RESULTS: The modified-Angoff method yielded the highest cut score, followed sequentially by the conventional method and the bookmark method. The classification agreement between the modified-Angoff and bookmark methods was 0.720 measured by Cohen’s κ coefficient. The intra-panelist classification consistency of modified-Angoff method was higher than bookmark method. However, the inter-panelist classification consistency was vice versa. The standard setting panelists’ survey results showed that the procedures of both methods were satisfactory, but panelists had more confidence in the results of the modified-Angoff method. CONCLUSION: The modified-Angoff method showed results that were more similar to those of the conventional method. Both new methods showed very high concordance with the conventional method, as well as with each other. The modified-Angoff method was considered feasible for adoption on the KMLE. The standard setting panelists responded positively to the modified-Angoff method in terms of its practical applicability, despite certain advantages of the bookmark method.