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The Southern Illinois University School of Medicine applies mastery learning concepts to an objectives-based curriculum and uses the Nedelsky method to assess mastery of core objectives. Provisions are made for remediating deficiences. The Nedelsky technique is used for determining an acceptable level of performance in multiple choice examinations administered to medical students. Advantages of using the Nedelsky method are: (1) standards are based on content; (2) it helps faculty realize item and response option difficulties; (3) the technique is easily understood; and (4) data supporting the validity of the technique are already available. Shortcomings include: the likelihood of reduced rating reliability and validity when obtained from a single instructor; decreased emphasis on other important test characteristics; and the possibility of consistently underestimating an acceptable level of performance. It was concluded that the Nedelsky technique worked best in the following situations: several instructors who are familiar with the test content are available; the test contains a relatively large number of items; and the acceptable level of performance is adjusted to more than procedural considerations. (MH)