Testing of medical students with open-ended, uncued questions

A written examination based on material covered in the first year of medical school (anatomy, physiology, biochemistry, and neuroscience) was administered to medical students immediately before they began the pathology course to assess their knowledge of the basic science content that is important for the study of pathology. In alternate years the questions were presented in the standard multiple choice question (MCQ) format or in an open-ended, uncued question (Un-Q) format. The students' mean scores obtained by these two testing methods were comparable. The discrimination indices, which measure the ability of the test questions to distinguish between students of varying ability, were comparable. The Kuder-Richardson Formula 20 (KR-20), an estimate of the precision of the test given, was 0.53 for MCQ and 0.63 for Un-Q. We conclude that the Un-Q format is an acceptable alternative to the MCQ format and it has several advantages over MCQ. Because the answer sheets for Un-Q tests can be scanned optically and graded by computers, we recommend them as an alternative to MCQ tests.