Table 2.

Frequency of items either removed or kept for the total exam score, presented by item, and for each quality monitoring guideline^a

Item	Number of times item is removed from the total score applying Guideline 1	Number of times item is removed from the total score applying Guideline 2	Number of times item is removed from the total score applying Guideline 3
1	0	7	18
2	0	18	21
3	0	17	22
4	9	1	1
5	0	11	21
6	17	3	2
7	0	1	14
8	0	12	22
9	0	10	21
10	0	14	22
11	0	3	11
12	2	0	7
13	0	2	10
14	0	6	20
15	0	1	11
16	0	15	21
17	0	15	22
18	0	14	22
19	1	6	18
20	2	1	6
21	0	15	22
22	2	1	6
23	0	14	22
24	0	17	21
25	0	15	22
26	3	1	3
27	0	8	19
28	1	1	4
29	0	4	20
30	6	1	2
31	0	1	11
32	0	12	21

^aGuideline 1: an item should be excluded from the examination if the item difficulty was ± two standard deviations from the average difficulty of the examination. Guideline 2: an item should be excluded if it fell ± two standard deviations from the passing score. Guideline 3: an item should be excluded if difficulty was less than 0.2 or more than 0.8 [15].