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A closer look at cueing effects in multiple-choice questions
L W Schuwirth1, C P van der Vleuten, H H Donkers
1Department of Educational Research, University of Limburg, Maastricht, Netherlands.
Medical Education
|January 1, 1996
Summary
Multiple choice questions can influence answers through positive or negative cueing effects. These effects decrease with greater expertise, with positive cueing aiding difficult items and negative cueing affecting easy items.
Area of Science:
- Medical Education
- Psychometrics
- Cognitive Psychology
Background:
- The format of assessment questions can influence examinee performance.
- Understanding potential biases in multiple-choice questions (MCQs) is crucial for accurate evaluation.
Purpose of the Study:
- To investigate the cueing effect in MCQs.
- To analyze how cueing effects vary across different levels of expertise.
Main Methods:
- Two parallel tests with identical patient case content were administered.
- Examinees (medical students, residents, general practitioners) completed tests with open-ended and then MCQs.
- Cueing effects (positive and negative) were identified and analyzed per expertise level.
Main Results:
- A significant difference in mean scores between question formats was observed.
- High inter-test correlations indicated consistent performance across formats.
- Both positive and negative cueing effects were present at all expertise levels.
- Cueing effects diminished with increasing professional expertise.
- Positive cueing was more prevalent in difficult items; negative cueing in easy items.
Conclusions:
- The format of questions, specifically MCQs, can introduce cueing effects impacting examinee responses.
- Expertise moderates the influence of cueing effects, with higher expertise leading to reduced susceptibility.
- These findings have implications for designing fair and valid assessments in medical education.