Table 1

Performance of UK graduates on marker items in the 1996/2 and 2001/3 diets (N = 852 and 555 respectively). Significance tests are shown for each item.

1: Recognised features of infectious mononucleosis include:

1996/2 Q.13

2001/3 Q.15


A: Petechial haemorrhages on the palate [True]

(Kendall's tau = -0.038, p = 0.153)

Right

81.0%

77.7%

NA

9.5%

11.9%

Wrong

9.5%

10.5%

B: a vesicular rash on the neck and trunk [False]

(Kendall's tau = -0.097, p < 0.001)

Right

76.1%

67.4%

NA

12.8%

15.1%

Wrong

11.2%

17.5%

C: aseptic meningitis [True]

(Kendall's tau = -0.178, p < 0.001)

Right

82.5%

67.4%

NA

10.8%

15.1%

Wrong

6.7%

17.5%

E: raised serum aspartate aminotransferase activity [True]

(Kendall's tau = -0.080, p = 0.003)

Right

91.4%

86.3%

NA

6.7%

10.8%

Wrong

1.9%

2.9%

Item D was not a marker item


2: A patient with chronic osteitis of the femur associated with a discharging sinus has a haemoglobin of 10.5 g/dL, MCV 78 fl, MCH 30 pg, WBC 10.8 × 109/L, platelets 420 × 109/L, and a normal blood film. The following statements are correct:

1996/2 Q.17

2001/3 Q.21


B: Antibiotic therapy is the probable cause of the blood picture [False]

(Kendall's tau = -0.078, p = 0.004)

Right

85.8%

79.6%

NA

8.1%

12.3%

Wrong

6.1%

8.1%

C: C-reactive protein levels will be normal [False]

(Kendall's tau = +0.118, p < 0.001)

Right

83.3%

91.5%

NA

6.3%

4.3%

Wrong

10.3%

4.1%

D: Parenteral iron therapy would be valuable in treating the anaemia [False]

(Kendall's tau = -0.080, p = 0.004)

Right

92.6%

87.9%

NA

4.5%

5.4%

Wrong

2.9%

6.7%

E: Abundant stainable iron will be found in bone marrow macrophages [True]

(Kendall's tau = -0.160, p < 0.001)

Right

45.5%

27.9%

NA

34.9%

44.1%

Wrong

19.6%

27.9%

NB Item D was not a marker item


3: Recognised features of acute poisoning due to theophylline include:

1996/2 Q.27

2001/3 Q.24


A: vomiting [True]

(Kendall's tau = -0.040, p = 0.139)

Right

92.7%

90.5%

NA

5.8%

7.6%

Wrong

1.5%

2.0%

B: convulsions [True]

(Kendall's tau = -0.056, p = 0.043)

Right

95.9%

93.3%

NA

3.2%

5.4%

Wrong

0.9%

1.3%

C: supraventricular tachycardia [True]

(Kendall's tau = -0.086, p = 0.001)

Right

88.4%

81.8%

NA

6.5%

12.8%

Wrong

5.2%

5.4%

D: hypokalaemia [True]

(Kendall's tau = -0.044, p = 0.093)

Right

69.0%

65.8%

NA

18.9%

17.1%

Wrong

12.1%

17.1%

E: metabolic acidosis [True]

(Kendall's tau = +0.040, p = 0.110)

Right

26.9%

30.8%

NA

39.8%

38.7%

Wrong

33.3%

30.5%


4: Recognised features of Wolff-Parkinson-White syndrome include:

1996/2 Q.33

2001/3 Q.33


A: an accessory connection between atria and the atrioventricular node [False]

(Kendall's tau = -0.177, p < 0.001)

Right

85.7%

71.1%

NA

3.3%

4.9%

Wrong

11.0%

24.0%

B: prolonged PR interval [False]

(Kendall's tau = -0.096, p = 0.001)

Right

94.4%

89.0%

NA

0.9%

3.6%

Wrong

4.7%

7.4%

C: prolonged QRS complex [True]

(Kendall's tau = -0.286, p < 0.001)

Right

76.2%

47.5%

NA

4.8%

9.0%

Wrong

19.0%

43.5%

D: paroxysmal ventricular tachycardia [False]

(Kendall's tau = -0.223, p < 0.001)

Right

65.8%

41.7%

NA

9.0%

15.2%

Wrong

25.1%

43.1%

E: dominant R waves in lead V1 of the ECG [True]

(Kendall's tau = +0.032, p = 0.213)

Right

71.1%

74.0%

NA

18.8%

17.5%

Wrong

10.1%

8.5%


5: The following clinical features suggest an organic basis for psychiatric symptoms:

1996/2 Q.40

2001/3 Q.41


A: disorientation in time [True]

(Kendall's tau = -0.074, p = 0.006)

Right

86.2%

80.0%

NA

3.3%

8.1%

Wrong

10.6%

11.9%

B: visual hallucinations [True]

(Kendall's tau = -0.122, p < 0.001)

Right

86.9%

77.3%

NA

3.2%

5.8%

Wrong

10.0%

17.0%

C: mutism [False]

(Kendall's tau = -0.150, p < 0.001)

Right

84.0%

70.6%

NA

8.9%

19.9%

Wrong

7.0%

9.6%

D: inability to retain new information [True]

(Kendall's tau = +0.071, p = 0.005)

Right

67.0%

72.9%

NA

9.2%

10.8%

Wrong

23.8%

16.2%

E: perseveration [True]

(Kendall's tau = -0.004, p = 0.885)

Right

45.3%

39.0%

NA

16.5%

29.2%

Wrong

38.1%

31.8%


6: Characteristic features of schizophrenia include:

1996/2 Q.43

2001/3 Q.40


A: memory impairment [False]

(Kendall's tau = +0.009, p = 0.725)

Right

91.3%

91.9%

NA

5.4%

4.7%

Wrong

3.3%

3.4%

B: auditory hallucinations in clear consciousness [True]

(Kendall's tau = -0.125, p < 0.001)

Right

98.5%

93.9%

NA

0.4%

1.8%

Wrong

1.2%

4.3%

C: incongruity of affect [True]

(Kendall's tau = -0.085, p = 0.001)

Right

81.9%

73.8%

NA

6.8%

13.9%

Wrong

11.3%

12.3%

D: feelings of panic in buses and shops [False]

(Kendall's tau = -0.037, p = 0.178)

Right

96.5%

94.9%

NA

2.0%

3.4%

Wrong

1.5%

1.6%

E: a feeling of being under the influence of an external force [True]

(Kendall's tau = -.038, p = 0.185)

Right

99.1%

98.2%

NA

0.7%

1.1%

Wrong

0.2%

0.7%


McManus et al. BMC Medicine 2005 3:13   doi:10.1186/1741-7015-3-13

Open Data