Cueing in multiple choice questions: a reliable, valid and economical solution

Area of Science:

• Medical Education
• Assessment Methods

Background:

• Traditional multiple-choice questions (MCQs) are widely used for medical student assessment.
• Concerns exist regarding the validity and scope of MCQs in evaluating complex clinical reasoning.
• The need for reliable and valid assessment tools in medical education is paramount.

Purpose of the Study:

• To evaluate the feasibility, reliability, and validity of computer-scored, open-ended questions for medical students.
• To compare the performance of open-ended questions against multiple-choice questions in assessing diagnosis and management.

Main Methods:

• Medical students were administered test questions covering diagnosis and management.
• Questions were presented in both multiple-choice and open-ended formats.
• Open-ended questions were designed for computer scoring.

Main Results:

• Open-ended questions proved feasible for administration to medical students.
• The reliability of open-ended questions was found to be comparable to multiple-choice questions.
• Open-ended questions demonstrated potentially higher validity in specific domains compared to MCQs.

Conclusions:

• Computer-scored, open-ended questions represent a viable alternative to traditional MCQs in medical education.
• This assessment format may enhance the evaluation of clinical decision-making skills.
• Further research can explore the application of open-ended questions across diverse medical competencies.