Applying the Bookmark method to medical education: Standard setting for an aseptic technique station

Introduction: The purpose was to evaluate the Bookmark standard-setting method for use on a performance-based assessment in medical education. Methods: We compared cutscores for Aseptic performance assessment using the modified Angoff, Hofstee and modified Bookmark methods. Results: The Angoff produced a cutscore of 62%, SD = 18 and a percent passing (pp) = 64%. The Hofstee cutscore was 71%, SD = 7 and pp = 46%. Bookmark mean cutscores were 65.9% SD = 10.7 and pp = 42% for advanced beginners; 83.6%, SD = 9.2 and pp = 17% for competent and the proficient category resulted in a cutscore of 96.4% SD = 3.9 and pp = 1%. Faculty judges found the Bookmark method to be an easy and acceptable method. Conclusions: The Bookmark method was acceptable to faculty, has reasonable quality metrics when compared to other methods and can be a practical tool for establishing standards in performance-based examinations. The Bookmark method could be useful for establishing multiple levels of competency using the Dreyfus criteria.