Related Experiment Video
Updated: Aug 21, 2026
Problem-Solving Before Instruction (PS-I): A Protocol for Assessment and Intervention in Students with Different Abilities
Published on: September 11, 2021
The impact of two multiple-choice question formats on the problem-solving strategies used by novices and experts
Sylvain P Coderre1, Peter Harasym, Henry Mandin
1Department of Medicine, University of Calgary, Health Sciences Centre, 3330 Hospital Drive NW, T2N 4N1, Calgary, Alberta, Canada. coderre@ucalgary.ca
Background:
Pencil-and-paper examination formats, and specifically the standard, five-option multiple-choice question, have often been questioned as a means for assessing higher-order clinical reasoning or problem solving. This study firstly investigated whether two paper formats with differing number of alternatives (standard five-option and extended-matching questions) can test problem-solving abilities. Secondly, the impact of the alternatives number on psychometrics and problem-solving strategies was examined.
Methods:
Think-aloud protocols were collected to determine the problem-solving strategy used by experts and non-experts in answering Gastroenterology questions, across the two pencil-and-paper formats.
Results:
The two formats demonstrated equal ability in testing problem-solving abilities, while the number of alternatives did not significantly impact psychometrics or problem-solving strategies utilized.
Conclusions:
These results support the notion that well-constructed multiple-choice questions can in fact test higher order clinical reasoning. Furthermore, it can be concluded that in testing clinical reasoning, the question stem, or content, remains more important than the number of alternatives.
More Related Videos
14:14The Innovation Arena: A Method for Comparing Innovative Problem-Solving Across Groups
Published on: May 13, 2022
13:20Online Repetitive Transcranial Magnetic Stimulation of Dorsomedial and Dorsolateral Prefrontal Cortex in Cognition Decision Making, and Cognitive Dissonance
Published on: December 5, 2025
Related Concept Videos
01:29Problem-Solving
01:29Theory of Attribution II: Kelley's Covariation Theory
01:21Cognitive Learning
E. C. Tolman's theory of purposive behavior emphasizes that much behavior is goal-directed. He argued that to understand behavior, we must look at the entire sequence of actions leading to a goal. For instance, high school students study hard, not just due to past reinforcement but also to achieve the goal of getting into a good college.
Tolman introduced the idea that behavior is influenced by...
02:01Factorial Design
02:01Group Design
01:14Decision Making: Traditional Method
First, a specific claim about the population parameter is decided based on the research question and is stated in a simple form. Further, an opposing statement to this claim is also stated. These statements can act as null and alternative hypotheses, out of which a null hypothesis would be a...