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: | Â | 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% |
| Â | NA | 9.5% | 11.9% |
| Â | 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% |
| Â | NA | 12.8% | 15.1% |
| Â | Wrong | 11.2% | 17.5% |
C: aseptic meningitis [True] (Kendall's tau = -0.178, p < 0.001) | Right | 82.5% | 67.4% |
| Â | NA | 10.8% | 15.1% |
| Â | 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% |
| Â | NA | 6.7% | 10.8% |
| Â | 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% |
| Â | NA | 8.1% | 12.3% |
| Â | 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% |
| Â | NA | 6.3% | 4.3% |
| Â | 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% |
| Â | NA | 4.5% | 5.4% |
| Â | 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% |
| Â | NA | 34.9% | 44.1% |
| Â | Wrong | 19.6% | 27.9% |
NB Item D was not a marker item | |||
3: Recognised features of acute poisoning due to theophylline include: | Â | 1996/2 Q.27 | 2001/3 Q.24 |
A: vomiting [True] (Kendall's tau = -0.040, p = 0.139) | Right | 92.7% | 90.5% |
| Â | NA | 5.8% | 7.6% |
| Â | Wrong | 1.5% | 2.0% |
B: convulsions [True] (Kendall's tau = -0.056, p = 0.043) | Right | 95.9% | 93.3% |
| Â | NA | 3.2% | 5.4% |
| Â | Wrong | 0.9% | 1.3% |
C: supraventricular tachycardia [True] (Kendall's tau = -0.086, p = 0.001) | Right | 88.4% | 81.8% |
| Â | NA | 6.5% | 12.8% |
| Â | Wrong | 5.2% | 5.4% |
D: hypokalaemia [True] (Kendall's tau = -0.044, p = 0.093) | Right | 69.0% | 65.8% |
| Â | NA | 18.9% | 17.1% |
| Â | Wrong | 12.1% | 17.1% |
E: metabolic acidosis [True] (Kendall's tau = +0.040, p = 0.110) | Right | 26.9% | 30.8% |
| Â | NA | 39.8% | 38.7% |
| Â | Wrong | 33.3% | 30.5% |
4: Recognised features of Wolff-Parkinson-White syndrome include: | Â | 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% |
| Â | NA | 3.3% | 4.9% |
| Â | Wrong | 11.0% | 24.0% |
B: prolonged PR interval [False] (Kendall's tau = -0.096, p = 0.001) | Right | 94.4% | 89.0% |
| Â | NA | 0.9% | 3.6% |
| Â | Wrong | 4.7% | 7.4% |
C: prolonged QRS complex [True] (Kendall's tau = -0.286, p < 0.001) | Right | 76.2% | 47.5% |
| Â | NA | 4.8% | 9.0% |
| Â | Wrong | 19.0% | 43.5% |
D: paroxysmal ventricular tachycardia [False] (Kendall's tau = -0.223, p < 0.001) | Right | 65.8% | 41.7% |
| Â | NA | 9.0% | 15.2% |
| Â | 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% |
| Â | NA | 18.8% | 17.5% |
| Â | Wrong | 10.1% | 8.5% |
5: The following clinical features suggest an organic basis for psychiatric symptoms: | Â | 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% |
| Â | NA | 3.3% | 8.1% |
| Â | Wrong | 10.6% | 11.9% |
B: visual hallucinations [True] (Kendall's tau = -0.122, p < 0.001) | Right | 86.9% | 77.3% |
| Â | NA | 3.2% | 5.8% |
| Â | Wrong | 10.0% | 17.0% |
C: mutism [False] (Kendall's tau = -0.150, p < 0.001) | Right | 84.0% | 70.6% |
| Â | NA | 8.9% | 19.9% |
| Â | 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% |
| Â | NA | 9.2% | 10.8% |
| Â | Wrong | 23.8% | 16.2% |
E: perseveration [True] (Kendall's tau = -0.004, p = 0.885) | Right | 45.3% | 39.0% |
| Â | NA | 16.5% | 29.2% |
| Â | Wrong | 38.1% | 31.8% |
6: Characteristic features of schizophrenia include: | Â | 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% |
| Â | NA | 5.4% | 4.7% |
| Â | 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% |
| Â | NA | 0.4% | 1.8% |
| Â | Wrong | 1.2% | 4.3% |
C: incongruity of affect [True] (Kendall's tau = -0.085, p = 0.001) | Right | 81.9% | 73.8% |
| Â | NA | 6.8% | 13.9% |
| Â | 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% |
| Â | NA | 2.0% | 3.4% |
| Â | 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% |
| Â | NA | 0.7% | 1.1% |
| Â | Wrong | 0.2% | 0.7% |