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Evaluation & the Health Professions
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A Follow-Up Study of "Dangerous Answers" in Four Medical Specialties

Barbara K. Kremer

American Board of Medical Specialties

Henry J. Mankin

Massachusetts General Hospital

We undertook this study to obtain further validation of a latent trait for dangerousness, identified by Mankin, Lloyd, and Rovinelli (1987), on certification examinations for medical specialists. "Dangerousness " was defined as any act of omission, or commission, in treatment which could result in a patient's death or injury. The method we employed involved asking panels of experts to retrospectively evaluate items on specilty examinationsfor dangerous answers. We then analyzed candidates' choices of dangerous answers. Four specialties participated in the study, and data from each were analyzed separately. Our results failed to support a latent trait for dangerousness. Nevertheless, we suggest that future studies employing alternative evaluation methods could yield support for a dangerousness trait, but consideration must be given to the potential costs of these studies.

Evaluation & the Health Professions, Vol. 13, No. 4, 489-503 (1990)
DOI: 10.1177/016327879001300409
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