Should There Be A Part II ABPMR Examination? A Psychometric Inquiry

Background: Certification by the American Board of Physical Medicine and Rehabilitation (ABPMR) requires passing both a written multiple choice examination (Part I) and an oral examination (Part II), but it has been unclear whether the two examinations measure the same or different dimensions of knowledge. Objective: To evaluate the concordance between the Part I and Part II examinations for ABPMR initial certification with regard to candidate performance on the examinations and their subsets. Our question is whether the Part II examination provides additional assessment of a candidate beyond what Part I provides. Design: Retrospective psychometric evaluation of deidentified board examination scores. Setting: ABPMR database of Part I and Part II examination scores. Participants: Candidates for the ABPMR Part I and Part II examinations after 2005, with a more detailed analysis of candidates for the Part I examination from 2014 to 2016. Examination scores of candidates who took the Part II examination both before and after the examination was standardized in 2005 were also used for an additional analysis. Methods: Correlations, simple linear regressions, and principal components analysis. Main Outcome Measurements: Correlation coefficients, variance analysis, and unexplained variance in the principal components analysis. Results: There is a weak to moderate correlation between performance on the Part I and Part II examinations: r = 0.33, P <.001. There is an additional dimension of assessment that is demonstrated on the Part II examination, with this being primarily in the domains of systems-based practice and interpersonal communication skills. Conclusion: The Part I and Part II examinations, although with some overlap, contribute different and meaningful components to the overall evaluation of candidates for board certification in PM&R. Level of Evidence: III.