Making students' marks fair: standard setting, assessment items and post hoc item analysis

Establishing test marks and reporting them to students is a difficult task for key medical educators. Failing a test is usually an unpleasant experience for any student. Therefore, medical educators must ensure the “reasonableness” of the pass mark and additionally, the quality of all test items. A poorly established pass mark and/or defective items may increase the number of students who fail unfairly. Furthermore, student complaints, legal actions and political issues may arise when pass marks are determined with poor procedural, internal or external validity. In any criterionreferenced assessment, the process of post hoc item judgment is essential and should be considered as a vital step in the validation of the standard setting method.