Problem-solving strategies used in anatomical multiple-choice questions

A Strategic Approach to Succeed on Clinical Case-Based Multiple-Choice Exams

Despite the importance of case-based multiple-choice question (CBMCQ) exams, medical educators rarely discuss strategies to systematically approach these questions, and literature on the topic is limited. Through trial-and-error, many students develop more refined and efficient approaches to answering CBMCQs that help them maximize the application of their knowledge base. In this article we present a structured six-step approach to answering CBMCQs, grounded in dual process theory. We provide strategies for success on CBMCQ-based exams and approaches to challenging question types. We also present tips for helping neurodiverse students. Medical educators can use this structured approach and the related tips to coach students on improving performance on CBMCQ-based exams.

Solving Not Answering. Validation of Guidance for Writing Higher-Order Multiple-Choice Questions in Medical Science Education

Problem-solving and higher-order learning are goals of higher education. It has been repeatedly suggested that multiple-choice questions (MCQs) can be used to test higher-order learning, although objective empirical evidence is lacking and MCQs are often criticised for assessing only lower-order, factual, or 'rote' learning. These challenges are compounded by a lack of agreement on what constitutes higher order learning: it is normally defined subjectively using heavily criticised frameworks such as such as Bloom's taxonomy. There is also a lack of agreement on how to write MCQs which assess higher order learning. Here we tested guidance for the creation of MCQs to assess higher-order learning, by evaluating the performance of students who were subject matter novices, vs experts. We found that questions written using the guidance were much harder to answer when students had no prior subject knowledge, whereas lower-order questions could be answered by simply searching online. These findings suggest that questions written using the guidance do indeed test higher-order learning, and such MCQs may be a valid alternative to other written assessment formats designed to test higher-order learning, such as essays, where reliability and cheating are a major concern.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-024-02140-7.

Rethinking Assessment Design: Evidence-Informed Strategies to Boost Educational Impact in the Anatomical Sciences

University assessment is in the midst of transformation. Assessments are no longer designed solely to determine that students can remember and regurgitate lecture content, nor in order to rank students to aid with some future selection process. Instead, assessments are expected to drive, support, and enhance learning and to contribute to student self-assessment and development of skills and attributes for a lifetime of learning. While traditional purposes of certifying achievement and determining readiness to progress remain important, these new expectations for assessment can create tensions in assessment design, selection, and deployment. With the recognition of these tensions, three contemporary approaches to assessment in medical education are described. These approaches include careful consideration of the educational impact of assessment-before, during (test or recall enhanced learning) and after assessments; development of student (and staff) assessment literacy; and planning of cohesive systems of assessment (with a range of assessment tools) designed to assess the various competencies demanded of future graduates. These approaches purposefully straddle the cross purposes of assessment in modern health professions education. The implications of these models are explored within the context of medical education and then linked with contemporary work in the anatomical sciences in order to highlight current synergies and potential future innovations when using evidence-informed strategies to boost the educational impact of assessments.