Exam Cut Score Tracking Form
Document and review cut score determinations for exams with input from panelists and supporting details.
Exam Title
*
Exam Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Exam Type
*
Please Select
Certification
Licensure
Placement
Formative Assessment
Summative Assessment
Other
Panelist/Evaluator Name
*
Panelist Role
*
Please Select
Subject Matter Expert
Psychometrician
Facilitator
Other
Standard Setting Method Used
*
Please Select
Angoff
Bookmark
Ebel
Contrasting Groups
Other
Panelist Ratings for Cut Score Determination
*
Rows
Recommended Cut Score (%)
Confidence Level (1-5)
Panelist 1
Panelist 2
Panelist 3
Panelist 4
Panelist 5
Panelist Rationale/Comments
Final Recommended Cut Score (%)
*
Supporting Documentation (e.g., meeting notes, reference materials)
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of
Was consensus reached on the cut score?
*
Yes
No
Additional Notes or Observations
Submit Cut Score Record
Should be Empty: