Criterion-referenced examinations: implications for the reporting and interpretation of examination results

The purpose of the American Board of Family Medicine (ABFM) certification/maintenance of certification examination is to measure the basic knowledge necessary to deliver high-quality care to patients and their families. More than 25 years ago, the ABFM became the first American Board of Medical Specialties board to introduce criterion-based methodology to establish the passing threshold for its examination. A criterion-referenced examination is one in which a particular score is required to pass, and the performance of those taking the examination is of no consequence in determining who passes or fails. In other words, all candidates taking the examination could theoretically pass if they met or exceeded the criterion-referenced passing score. Furthermore, the examination is equated across forms and administrations, meaning candidates are not advantaged or disadvantaged by having received a particular version of the examination or by taking it at a particular time of the year.