Purpose. Using patient video clips to evaluate examinees' skills in interpreting physical examination findings is possible with computer-based testing, but the psychometric properties of video-based questions are unknown. Method. We developed parallel test questions incorporating video clips or text descriptions of abnormal neurologic findings and administered them to 106 fourth-year medical students finishing their Neurology Clerkship. Results. Overall, video-based questions had comparable difficulty and discrimination compared to analogous text-based questions. Preliminary studies indicated similar reliability with text- and video-based questions. Conclusions. The inclusion of patient video clips in computer-based testing is feasible from technical, practical, and psychometric perspectives. Further study is needed to gather validity evidence for this novel question format.
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