Examination Blueprints

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Examination Blueprints

Examinations can sample only a portion of the material presented in a course. Errors due to sampling needs to be minimized to allow an exam to assess student mastery of material presented in a course. A test blueprint provides one mechanism to reduce errors from sample bias.

An examination blueprint also insures that the examination reflects the instructional objectives. As an example, for a test involving only renal physiology, a test blueprint based on the Renal section of the Medical Physiology Learning Objectives might look like this:

	Bloom’s Taxonomy Cognitive Domain Level
	Knowledge	Comprehension	Application and Analysis	∑ (% of exam)
Body Fluids				9%
Structure of Kidney and Nephron				6%
Renal Clearance				5%
Glomerular Filtration rate and Renal Hemodynamics				16%
Transport Properties of Nephron Segments				10%
Urine Concentration and Diluting				12%
Na Balance and Regulation of Extracellular Fluid Volume				12%
K Balance				6%
Ca and Phosphate Balance				6%
Acid-Base Balance				13%
Integrative and Pathophysiological Aspects				5%
∑ (% of exam)				100%

The far right column was calculated based on the number of objectives assigned to that topic as a % of the total number of renal objectives. For example, of the 79 renal objectives, 7 dealt with body fluids, so 7/79 =.0886, rounded to 9%. This approach assumes that the number of objectives on a topic matches the importance of the topic in the course. As an alternative, the lecture time devoted to a topic can also be the basis for calculating the % weight in that column.

The bottom row is based on the instructor expectation for the course. For my course, I expect the students to master certain facts (definitions, normal values, etc.), and the exam is designed so that 40% of the exam tests facts. The remainder of the exam tests higher cognitive skills. The NBME USMLE Step 1 has a different expectation. Few if any of the USMLE physiology questions test facts, with most of the questions testing comprehension and application. The allocation is based on the instructional goals.

The actual number of exam items assigned to each cell in the table can vary. For example, the fact-based questions would be more heavily represented in the structure and the transport properties cells, and the application questions would be more heavily represented in the pathophysiology cell. The numbers in each cell can vary, but the total in each column should come close to matching the number predicted by the blueprint. If not, the exam does not accurately reflect the instructional goals set for the course.