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Choosing medical assessments: Does the multiple-choice question make the grade?
Hannah Pham1, Monique Trigg2, Shaopeng Wu1
1Department of Surgery, University of Adelaide, Adelaide, South Australia.
Education for Health (Abingdon, England)
|December 12, 2018
Summary
Multiple-choice questions (MCQs) effectively assess higher-order skills like short-answer questions (SAQs). Using MCQs alone for assessment is viable if high-quality, higher-order cognitive skill items are employed.
Area of Science:
- Medical Education
- Assessment and Evaluation
Background:
- Short-answer questions (SAQs) and multiple-choice questions (MCQs) are believed to measure similar constructs.
- Despite this, SAQs remain in use for medical student assessments.
Purpose of the Study:
- To evaluate if assessment using MCQs alone yields comparable outcomes to assessments using SAQs.
- To analyze the impact of item-writing flaws (IWFs) on examination results.
Main Methods:
- A prospective study involving 276 medical students in a mock examination.
- The exam comprised 40 MCQs and 40 SAQs, matched for cognitive skill and content.
- SAQs were graded by three independent markers; the influence of IWFs was assessed.
Main Results:
- High intraclass correlation coefficients (ICCs) were observed (0.75 for Year IV, 0.68 for Year V).
- MCQs were more susceptible to IWFs, but IWFs had a greater impact on SAQ outcomes.
- Removing IWFs from Year V SAQs enabled 39% of failing students to pass.
Conclusions:
- MCQs can effectively assess higher-order cognitive skills, comparable to SAQs.
- MCQs can be utilized as a sole format for written assessments, provided items target higher-order skills.
- Item-writing flaws significantly influence pass/fail decisions in assessments.
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