Total scores on a patient management problem (PMP) test can be divided into two subscores-one based on all options keyed select; the other, on all options keyed omit. A pervasive feature of the component scores, across a variety of examinations studied, is that they are correlated negatively. This negative correlation is reflected in reduced discrimination indices and reliability for the total test scores. The implications of this finding for previous research with PMPs are reviewed.
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