Thinking differently - Students' cognitive processes when answering two different formats of written question

Area of Science:

• Medical Education
• Cognitive Psychology

Background:

• Single-best answer questions (SBAQs) are widely used but prone to cueing.
• Very short answer questions (VSAQs) present a potential alternative for assessment.

Purpose of the Study:

• To investigate cognitive process variations between SBAQs and VSAQs.
• To determine if student performance levels influence question-answering strategies.

Main Methods:

• A 'think aloud' study involving 21 final-year medical students from five UK medical schools.
• Students verbalized thought processes for both SBAQs and VSAQs.
• Response strategies were coded and quantified.

Main Results:

• VSAQs elicited more analytical reasoning (e.g., identifying key features).
• SBAQs were associated with increased test-taking behaviors, including using answer options.
• Students expressed more uncertainty with VSAQs.
• High-performing students employed more analytical reasoning.

Conclusions:

• VSAQs appear to foster more genuine clinical reasoning skills.
• Observed differences in cognitive approaches underscore the need for targeted instruction in clinical reasoning and managing uncertainty.