| Abstract: | Objectives: The Credential Examination on Public Health Core Course Competencies (or the Core Competency Exam) was conducted annually in Taiwan for 12 years, from 2009 to 2020. This study aims to analyze the initiation and development of the exam, encompassing the creation of the questions database and evaluation of pass rates, item difficulty, and the discrimination index, and provide directions for enhancing core course competencies. Methods: This study sought to understand the history of the exam, its development, and its annual conduction by reviewing documents provided by the Taiwan Public Health Association. Additionally, the exam questions on five subjects (Biostatistics, Epidemiology, Social and Behavioral Sciences, Environmental and Occupational Health, and Public Health Policy and Administration) were analyzed to determine their accuracy, difficulty, and discrimination ability. The statistical analyses included calculation of frequencies, percentages, and Pearson’s correlation coefficients, analysis of variance, nonparametric analysis of variance, and chi-square tests. Results: A total of 4,225 individuals registered for the exam between 2009 and 2020, and 2,183 of them passed, which was approximately 60.4% of the nonabsentees. From 2010, only multiple-choice questions were used for all five subjects. Therefore, item difficulty and the discrimination index were analyzed for the data collected from 2010 to 2020. The average pass rate was approximately 60% (range: 55.6%–71.5%). The participants scored lower in Biostatistics (average accuracy and standard error across problems: 0.54 ± 0.01) and Environmental and Occupational Health (0.51 ± 0.01) than in Epidemiology (0.56 ± 0.01), Social and Behavioral Sciences (0.67 ± 0.01), and Public Health Policy and Administration (0.58 ± 0.01). However, the discrimination index for Biostatistics (0.39 ± 0.01) was significantly higher (p < 0.001) than that for the other four subjects (range: 0.14–0.31). The before-test problem difficulty (easy, fair, or difficult) and the after-test problem accuracy (high, medium, or low) were significantly similar (p < 0.001) for all subjects except Biostatistics. Conclusions: The pass rate of the Core Competency Exam was found to have been stable. However, the difficulty level and item discrimination index varied among the five subjects. Focusing on specific topics and developing reference textbooks for these subjects may be necessary. © 2024, Taiwan Public Health Association. All rights reserved. |
