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Pushing Critical Thinking Skills With Multiple-Choice Questions: Does Bloom's Taxonomy Work?
Nikki L Bibler Zaidi1, Karri L Grob, Seetha M Monrad
1N.L.B. Zaidi is associate director of evaluation and assessment, Office of Medical Student Education, University of Michigan Medical School, Ann Arbor, Michigan. K.L. Grob is assistant director of evaluation and assessment, Office of Medical Student Education, University of Michigan Medical School, Ann Arbor, Michigan. S.M. Monrad is science and clinical trunk director, Office of Medical Student Education, and clinical associate professor of internal medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. J.B. Kurtz is a second-year medical student, University of Michigan Medical School, Ann Arbor, Michigan. A. Tai is assistant professor of internal medicine and of microbiology and immunology, University of Michigan Medical School, Ann Arbor, Michigan. A.Z. Ahmed is assistant professor of internal medicine, University of Michigan Medical School, Ann Arbor, Michigan. L.D. Gruppen is professor, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan. S.A. Santen is assistant dean for educational research and quality improvement, Office of Medical Student Education, and associate professor and chair of education, Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
Medical school assessments using multiple-choice questions (MCQs) can evaluate higher-order thinking skills. Understanding cognitive processes in test-takers is key to accurately measuring clinical reasoning and knowledge application.
Area of Science:
- Medical Education
- Cognitive Science
Background:
- Medical school assessments must develop higher-order thinking skills for clinical reasoning.
- Multiple-choice questions (MCQs) are common assessment tools, but their cognitive demands can vary.
- Bloom's taxonomy is used to classify question difficulty and cognitive skills assessed.
Purpose of the Study:
- To describe the cognitive processes examinees use when responding to MCQs.
- To explore how faculty question writers and examinees may differ in their perception of MCQ cognitive levels.
- To identify factors influencing the interaction between test material and cognitive processes.
Main Methods:
- This perspective discusses cognitive processes involved in MCQ test-taking.
- It analyzes the potential discrepancies between question writer and examinee cognitive level perceptions.
- It reviews literature on Bloom's taxonomy and its application in medical education assessments.
Main Results:
- Faculty and examinees may perceive the cognitive demands of MCQs differently.
- Factors such as knowledge and expertise influence cognitive processes during assessments.
- The cognitive level required to answer an MCQ may not align with the writer's intent.
Conclusions:
- Accurate assessment of higher-order thinking skills requires understanding examinee cognitive processes.
- Further research is needed to align MCQ design with intended cognitive skill assessment.
- Optimizing MCQs can enhance clinical reasoning and knowledge acquisition in medical students.
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