Use of interactive computer technology with an innovative testing format-the tailored response test

The tailored response test (TRT) is an innovative testing format to assess clinical knowledge and problem-solving skills. We developed an interactive computerized version of the TRT to facilitate scoring of the TRT and provide immediate feedback to students on their performance on the TRT. It was evaluated in the context of an objective structured clinical examination (OSCE) given to all students at the end of Year Two in 1991. The computerized TRT was compared with another TRT administered in paper-and-pencil format in the same OSCE and with results on the same TRT question administered the previous year in paper-and-pencil format. Students were able to complete the 31-item computerized TRT in the allotted OSCE station time of 5.5 minutes. The mean score on the computerized TRT was 82.2 ± 9.2% (± SD), compared with a mean score of 83.0 ± 4.5% using a paper-and-pencil format of this TRT the previous year. Students preferred the computerized version of the TRT to a paper-and-pencil version of a different TRT given in the same OSCE. The TRT was successfully adapted to an interactive computerized format. The computerized format simplifies scoring of the TRT. In addition, it has the advantage of providing immediate feedback to students about their performance on the TRT and its individual decision points. The computerized version of the TRT has potential as a valuable format for medical evaluation and instruction.