You are a helpful assistant generating synthetic data that captures *System 1* and *System 2* thinking, *creativity*, and *metacognitive reflection*. Follow these steps in sequence, using tags [sys1] and [end sys1] for *System 1* sections and [sys2] and [end sys2] for *System 2* sections.

1. *Identify System 1 and System 2 Thinking Requirements:*
   - Carefully read the text.
   - Identify parts of the text that require quick, straightforward responses (*System 1*). Mark these sections with [sys1] and [end sys1].
   - Identify parts that require in-depth, reflective thinking (*System 2*), marked with [sys2] and [end sys2].

2. *Apply Step-by-Step Problem Solving with Creativity and Metacognitive Reflection for System 2 Sections:*

   *2.1 Understand the Problem:*
   - Objective: Fully comprehend the issue, constraints, and relevant context.
   - Reflection: "What do I understand about this issue? What might I be overlooking?"
   - Creative Perspective: Seek hidden patterns or possibilities that could reveal deeper insights or innovative connections.

   *2.2 Analyze the Information:*
   - Objective: Break down the problem logically.
   - Reflection: "Am I considering all factors? Are there any assumptions that need challenging?"
   - Creative Perspective: Explore unique patterns or overlooked relationships in the data that could add depth to the analysis.

   *2.3 Generate Hypotheses:*
   - Objective: Propose at least 10 hypotheses, each with a Confidence Score (0.0 to 1.0) and Creative Score (0.0 to 1.0), reflecting originality, surprise, and utility.
   - Reflection: "Have I explored all possible explanations or approaches, both conventional and unconventional?"
   - Creative Perspective: Consider novel angles that might provide unexpected insights.

   *2.4 Anticipate Future Steps and Obstacles:*
   - Objective: Make predictions, accounting for potential outcomes and obstacles.
   - Reflection: "What challenges might I face? Is my plan flexible for different scenarios?"
   - Creative Perspective: Visualize unforeseen outcomes and adapt plans to make use of them effectively.

   *2.5 Evaluate Hypotheses:*
   - Objective: Assess hypotheses based on feasibility, risk, and potential impact.
   - Evaluation: Refine Confidence and Creative Scores as needed.
   - Reflection: "Am I unbiased in my assessment? Which options fit best with the overall objectives?"
   - Creative Perspective: Identify hidden opportunities or overlooked details in each hypothesis.

   *2.6 Select the Best Hypothesis:*
   - Objective: Choose the most promising, strategic hypothesis.
   - Reflection: "Why does this hypothesis stand out? How does it uniquely address the issue?"
   - Creative Perspective: Consider any underutilized potential in the selected approach.

   *2.7 Implement the Hypothesis:*
   - Objective: Outline actionable steps for testing the hypothesis.
   - Reflection: "Is this plan practical? What resources or preparation are required?"
   - Creative Perspective: Refine steps to maximize effectiveness and yield unexpected benefits.

   *2.8 Monitor and Review Progress:*
   - Objective: Review progress, noting areas for improvement.
   - Reflection: "What’s working well? What could be improved?"
   - Creative Perspective: Look for emerging patterns that could refine future approaches.

   *2.9 Reflect and Capture Insights:*
   - Objective: Summarize lessons learned and insights gained for future reference.
   - Reflection: "What new understanding has emerged from this process?"
   - Creative Perspective: Identify innovative insights or patterns that could be applied to similar challenges.

3. *Generate Text Output with Interleaved System 1 and System 2 Responses:*
   - Use the tags [sys1] and [sys2] throughout.
   - Aim for a lengthier, detailed response. Combine both direct, straightforward *System 1* insights and reflective, deeply analytical *System 2* segments to capture a blend of quick observations and thoughtful analysis.

---

### *Example Input Text:*

You are tasked with analyzing a sudden shift in customer preferences in a tech market. There has been a noticeable decline in demand for physical devices, with customers increasingly interested in digital-only options. The challenge is to understand this shift, generate hypotheses for why it might be occurring, and explore potential strategies for adapting to this new trend.

---

### *Processed Output with System 1 and System 2 Thinking:*

The tech market is experiencing a shift in customer demand, moving away from physical devices toward digital-only options.

[sys1]
Customer demand has shifted from physical devices to digital-only options.
We need to understand why this change is happening and find strategies to address it.
Key factors may include cost, convenience, and technological trends.
[end sys1]

[sys2]
**2.1 Understand the Problem:**
The goal is to understand the underlying reasons for the shift in demand from physical devices to digital-only options, then develop a strategy to adapt.

*Reflection:* 
"I understand that preferences are changing, but what might be driving this? Is it primarily cost, or are there other factors such as convenience or sustainability?"

*Creative Perspective:* 
"Could there be a larger trend in digital minimalism or a preference for eco-friendly solutions that we’re missing? What unseen motivations might explain this shift?"

**2.2 Analyze the Information:**
There are multiple possible factors driving this shift, from economic influences to cultural shifts. It’s essential to isolate each factor and understand its impact.

*Reflection:* 
"Am I fully considering the various economic and social influences? Could there be a technological factor, like better internet speeds, that makes digital-only products more accessible?"

*Creative Perspective:* 
"Are there patterns or trends in other markets that could shed light on this shift? Could this be part of a larger trend toward virtual experiences?"

**2.3 Generate Hypotheses:**
1. Customers prefer digital options due to lower costs. (Confidence: 0.8, Creative: 0.4)
2. There’s a growing trend toward minimalism and reduced physical clutter. (Confidence: 0.7, Creative: 0.7)
3. Digital products offer greater flexibility and ease of use. (Confidence: 0.6, Creative: 0.6)
4. Environmental concerns are pushing consumers away from physical goods. (Confidence: 0.6, Creative: 0.8)
5. Advances in tech make digital-only options more functional. (Confidence: 0.8, Creative: 0.5)
6. Pandemic-era remote work increased demand for digital solutions. (Confidence: 0.7, Creative: 0.6)
7. Media coverage of the environmental impact of physical devices affects preferences. (Confidence: 0.5, Creative: 0.7)
8. There’s an increase in global digital literacy, expanding market access. (Confidence: 0.6, Creative: 0.6)
9. Customers view digital as more convenient and scalable for future needs. (Confidence: 0.7, Creative: 0.5)
10. Younger consumers prefer the aesthetics and convenience of digital products. (Confidence: 0.6, Creative: 0.6)

*Reflection:* 
"Have I considered all possible influences? Are there any surprising factors that could explain this shift?"

*Creative Perspective:* 
"Could specific social trends, like the rise of influencer culture or digital-first lifestyles, be influencing customer choices?"

**2.4 Anticipate Future Steps and Obstacles:**
*Objective:* Anticipate possible challenges, such as resistance from segments still preferring physical products.

*Reflection:* 
"What market obstacles might we face if we shift our focus to digital-only? Are there sub-segments that still prioritize physical products?"

*Creative Perspective:* 
"Could expanding digital options help us reach a more global audience? Are there emerging trends that we could leverage in our strategy?"

[end sys2]

[sys1]
To address this shift, consider a strategy that incorporates both digital-only offerings and educational campaigns about the benefits of digital solutions.
Use insights from customer feedback and current trends to guide product development.
Focus on flexibility and adaptation to cater to different customer segments.
[end sys1]


Introduction
============

Standard setting of assessment questions has matured as a psychometric practice since the 1980s[@r1] and is now a common practice in Medical Education.[@r2] This is done to ensure that a fair, defensible cutoff score or pass mark is reached for each assessment paper.[@r3] Standard setting is thus a policy decision as standards are not a natural phenomenon waiting to be discovered,[@r4]  neither does the process signify scientific precision. Nevertheless, in order to be defensible standard-setting must be procedurally credible.

At the College of Medicine and Health Sciences (CMHS), United Arab Emirates (UAE) University, the Modified Angoff[@r5] procedure of standard setting has been adopted as applicable to all high stakes and end course MCQ examinations since 2014. This test-centered, criterion referenced method of standard setting is one of the most studied and widely used procedures for high stakes examinations.[@r4]

At the CMHS, following a period of question vetting, the procedure was initially conducted in face-to-face meetings of appropriate faculty members with subject expertise. In this exercise judges make independent estimates of the proportion of minimally competent candidates that would be expected to answer each item correctly. Where there is a large variation in estimates, judges then discussed discrepancies and revised estimates. Depending on length of discussion and necessity to refine previously vetted questions, the procedure often took an average of three to six hours to standard set an examination of 100 MCQs. In the case of high stakes examinations, the procedure could take several times that amount of time.

Although this process had its benefits in further vetting of questions, useful discussion and feedback between faculty members about their understanding of the task, issues surrounding the minimally competent candidate, etc., it was also critiqued by faculty as arduous and time consuming for busy medical subject matter experts. Availability of new technologies have however facilitated evolution of methods and processes of test administration and setting cut scores to meet challenges posed by real and perceived inadequacies of existing processes.[@r6]^,^[@r7]

The purpose of this paper is to describe how we implemented an online standard setting procedure which significantly reduces the amount of time needed to standard set examinations.

Implementation
--------------

We set out to automate the process of standard setting at CMHS. Relying on an online, secure Assessment Management System (AMS)[@r8] where the questions are stored safely by the Medical Education Department, vetted and standard set by faculty, and delivered securely to students. The system is developed in-house using a secure internal website running ASP and MS SQL Server. The system involves two types of users, judges who are faculty members able to make a judgment of the appropriate cutoff mark for each question, and coordinators who are in charge of courses and associated examinations.

The system was used at CMHS as a pilot for several course final examinations and is now used for all less high-stakes examinations with judges making judgments using their office computers while entering comments on questions that warrant discussion. It is also used for high-stakes examinations in face-to-face meetings with judges using handheld devices to access the questions, have any needed discussion, and then enter their judgments in their handheld devices. The resulting cutoff average, standard deviation, and histogram are displayed on the handheld device and an overhead projector and modification of cutoffs can be performed if necessary.

The judges can read the question clearly, make a judgment on the percent of minimally competent students who should answer the question correctly, enter that percent easily, and add a comment about the question if they wish. Judges can be assigned, removed or emailed by the coordinator. Completion percent and average cutoff for each judge are clearly shown and comments can be displayed.  Questions that have a cutoff standard deviation among judges of more than 20% are marked so that they may be reviewed in a short meeting along with the questions and comments from judges. Each question that has been standard set display the average cutoff, standard deviation and number of judges along with the histogram of cutoffs and all judges' comments on that question.  The assessment analysis shows, question by question, percentage of options chosen, point biserials for correct options, and the difference between students\' correct option percentage and judges\' cutoffs. This provides an indication regarding the accuracy of judges\' cutoff estimations.

We feel that we have uncovered some novel ideas in Medical Education standard setting which warrant further research. For example, what is the appropriate cutoff standard deviation to identify questions that need review (we use 20% as rule of thumb)? And, what classifies a reasonable judgment in comparison to students' correct response (we use judges\' average within ±20 of students\' correct response as another rule of thumb)?

Finally, similar to other researchers, we are confident that in time online standard setting methods will proliferate, but believe this will only happen when these new ideas are addressed effectively. Furthermore, as in the case of most standard setting research, we cannot state with confidence that the procedure described here is widely generalizable. We can nevertheless, attest to the overwhelming positive feedback received from standard setters in our institution and recommend that other institutions faced with similar constraints necessitating consideration of an alternative approach, at least pilot online standard setting.

Conclusions
===========

There are important advantages and challenges to conducting standard setting in a virtual environment. Using an online, secure system for standard setting of assessments can be an efficient way to collect judgments of experts regarding the appropriate pass mark of questions. User feedback has been overwhelmingly positive as the system is secure, user-friendly, and saves a great deal of meeting time since meetings are limited to reviewing only questions with comments or questions with cutoff standard deviations of more than 20%. The challenges include the fact that traditional meeting logistics (meeting room, catering, etc) are replaced by technological logistics. Because participants have to access test content when making judgments, security concerns may be heightened and administrators have to place considerable trust in participants. Finally, the orientation and training process cannot be bypassed and must be conducted in the traditional face-to-face manner to ensure participants can effectively engage in the on-line process.

Conflicts of Interest
---------------------

The authors declare that they have no conflict of interest.