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Material cultural researchers should continue to address correlated change in items of material culture within their wider cultural context (Bettinger 2009; Eldredge 2009).
To make such claims would be to assume a one-to-one correspondence between a one-unit change in items correct and a one-unit change in knowledge.
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However, only the change in item 3 (analysing/evaluating) is statistically significant.
The interpretation of change in item values is illustrated in Table 1.
Wilcoxon Signed-Rank tests were conducted to determine pre-to-post change in item scores.
The main idea of the LLRA model is not to consider longitudinal change as a change in person parameters, but rather as a change in item parameters.
In order to visualize the change in item difficulty estimates, the baseline estimates were plotted against all other evaluation time points [ 54].
An explanation for the not-significant change in item 6 (Management) may be that the potential change was not acknowledged in the actual rating: absence of sub-items was not justified or sub-items were not absent.
As the exclusion of triplets containing one-digit numbers resulted in a substantial change in item characteristics per experimental condition, a subset of 38 triplets was chosen from each condition for having matched stimulus properties (see Table 1).
The significant change in item 7 (Closure) can also be explained by the lack of clarity in the MAAS-Global protocol where the assessor has to score a question near the end of a consultation: either under Closure as 'general question', or under Management (item 6) as 'asking for patient's response'.
When the number of items is fixed and the number of options is manipulated, mixed results and recommendations are reported; while some studies have identified a small or negligible change in item difficulty or discrimination for different option numbers [ 7, 14- 17], others have found decreases in difficulty and discrimination for smaller option numbers [ 3].
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