Assessment by modified essay type questions and multiple-choice questions in medical undergraduate students: Which are better in addressing higher cognitive skills?
Background: Modified essay-type questions (MEQs) and multiple-choice questions (MCQs) are important tools in summative assessment for MBBS students in the newly introduced competency-based medical education curriculum. The existing literature suggests that MCQs are better at addressing higher cognitive levels as compared to MEQs.
Aims and Objectives: The aim of our study was to compare the effectiveness of MEQs and MCQs in assessing higher cognitive levels. Item writing flaws in the MEQs and MCQs were also studied.
Materials and Methods: 90 MCQs and 50 MEQs (153 stages) of physiology for the academic years 2019–2020 and 2020–2021 from different university question papers in India were selected by randomization. Two independent assessors assigned taxonomy levels according to modified Bloom’s taxonomy to the MCQs and MEQs. The Kappa score of agreeability was calculated. The final percentages of MCQs and MEQs at all three levels were calculated.
Results: MEQs assessed Level 3 better than MCQs in both 2019 and 2020 examinations. MCQs were better in assessing Level 2 than MEQs both the years. The most common item-writing flaws were errors in formatting, spelling, and grammar.
Conclusion: Both MEQs and MCQs are equally effective in assessing higher cognitive levels. The majority of questions asked (about 50%) were simple recall types, which need to be addressed.
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