Duncan et al. (2009) argued that the contexts of assessment tasks could prove problematic for teachers and researchers attempting to identify the level of students' understanding, and that the context of a task or item may influence the way students respond, with students exhibiting higher performance in one context but lower performance in another.
The NIS is a brief, self-report measure originally designed to assess neurocognitive impairment (NCI) by having patients rate a range of items that may influence cognitive functioning.
IRT provides a modern and reputedly superior alternative to classical test theory, as it discriminates more finely among different sources of error, especially regarding features of individual items that may influence their performance [ 23].
The theories of Wilson and Cleary [ 4] and the model described by Smith et al. [ 5] would suggest that the single activities identified from Q1 and Q2 may act as salient points of reference for individuals when they consider the usual activities item, and may influence how they perceive their overall performance of multiple tasks.
Following expectancy-value theory, the present study particularly focusses on interactions between person- and item-level factors that may influence expectations about completing an item successfully.
Each model was adjusted for other individual level cognitive variables (e.g. for the intention model, adjustments were also made for refusal self-efficacy scale and dichotomous attitude items) since these variables may influence each other [ 8, 15].
These results indicate that availability of items in the home chamber may influence the results, which should be taken into account when designing motivation studies similar to the one performed in this study.
These findings should inform other researchers about the importance of considering the meaning of items and social norms that may influence responses.
Future research and testing is required for the OMS-HC pertaining to additional items and other variables that may influence responses of health care providers such as demographic variables.
Likewise for monotonicity, it is recommended to only remove one item at a time since IIO violations of other items may be influenced by the inclusion or exclusion of any particular item.
