Using in-depth analysis of post-examination reports to improve teaching-assessment coherence

Post-examination reports include a variety of data relating to item difficulty and discrimination. We tested the hypothesis that discussing an in-depth analysis of these reports with individual faculty members could improve the coherence of the teaching-assessment process. In a newly developed 10-week course for first year medical students, data from post-examination reports regarding item difficulty (p-diff) and point-biserial correlation (PBS), a discrimination index, were summarized for each faculty member with significant teaching in the course. In discussion between the course director and each faculty member following the course, these data summaries were used to develop plans for improved coupling of teaching and assessment. Following the second rendition of the course, data indicate that mean item p-diff increased (78.8 vs. 82.7%), as did top 27% student (90.9 vs 93.8%) and bottom 27% student mean item p-diff (65.5 vs. 69.0%). The fraction of items scoring at or above 90% increased (23.5 vs. 32.4%), the fraction of items with a failing average decreased (18.6 vs. 11.5%), and the A/F ratio increased (1.7 vs. 2.8). For the top 27% of students, the fraction of items scoring at or above 90% increased (69.6 vs. 82.8%) and the fraction of items scoring below 80% decreased (10.9 vs. 5.0%). These improvements in performance occurred without a reduction in item discrimination ability, as indicated by a small, but insignificant, increase in PBS (0.279 vs. 0.292). There was a tendency toward better discrimination, as the fraction of items with PBS at or above 0.20 increased (76.7 vs 82.8%). Data for individual faculty with significant teaching in the course indicate improved outcomes for each. While effective teaching can never be reduced to a set of numbers, these results suggest that interventions using data from post-examination reports can be used reflectively to guide improvements in teaching-assessment coherence. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.