Repeated use of computerized case simulations in a test format does not present a security risk

Background: Computer-based examination formats permit evaluation of patient care strategies in a realistic context. Because such examinations are complex and difficult to develop, the same case simulations must often be used on multiple occasions. Methods: To determine if repeated, serial administration of computerized case simulations influences performance, 8 simulations were administered over 2 consecutive years to 252 third-year medical students at the conclusion of 16 surgical clerkship rotations (8 per year). One-way analyses of variance were used to compare scores across rotations during the year and to compare scores between 2 consecutive academic years. Scheffe pairwise comparisons were used to identify trends within each academic year. Results: The data demonstrate an increase in scores across rotations during the year. There is, however, no difference between scores in successive years. Conclusions: The data are consistent with an increase in knowledge during the course of the year, without evidence that test information transfer influences the performance of successive classes.