Comparison of traditional essay questions versus case based modified essay questions in biochemistry

Adult learning involves the analysis and synthesis of knowledge to become competent, which cannot be assessed only by traditional assessment tool and didactic learning methods. Stimulation of higher domains of cognitive learning needs to be inculcated to reach a better understanding of the subject rather than traditional assessment tools that relies primarily on rote learning. So, there is need for an alternative assessment tool. Hence, we conducted a study where we used case-based examination methodology. This study was conducted on 226 Ist year MBBS students in Maulana Azad Medical College, New Delhi (India). Based on their compiled internal assessment marks according to monthly formative assessment, students were categorized into 3 groups (I: 0-7; II: 8-14; III: 15-20) marks out of 20 marks respectively. Two sets of question papers were set by three examiners, on the same topics carrying 50 marks each. The first set was based on traditional assessment tool (Paper-A) with recall questions and second set on case-based assessment method (Paper-B). Out of 226 students, 146 were males and 80 were females. For all groups, marks (mean ± SD) in Paper B were found to be higher (18.40 ± 4.29, 30.01 ± 4.12, and 40.33 ± 1.15) as compared to paper A (10.88 ± 4.34, 21.96 ± 7.34, and 31.50 ± 6.94) respectively. However, we found that there was significant (p < 0.001) difference in group I & II, whereas with group III, difference was found to be insignificant. Hence, we concluded that students performed better in case-based assessment rather than traditional method due to their direct involvement. Thus, for better memory and deeper learning the subjects can be assessed by case-based assessment method.