Comparison of level of cognitive process between case-based items and non-case-based items of the interuniversity progress test of medicine in the Netherlands.

Dario Cecilio-Fernandes,Wouter Kerdijk,Andreas Johannes Bremers,René Anton Tio,Wytze Aalders

doi:10.3352/jeehp.2018.15.28

Abstract

PurposeIt is assumed that case-based questions require higher-order cognitive processing, whereas questions that are not case-based require lower-order cognitive processing. In this study, we investigated to what extent case-based and non-case-based questions followed this assumption based on Bloom’s taxonomy.MethodsIn this article, 4,800 questions from the Interuniversity Progress Test of Medicine were classified based on whether they were case-based and on the level of Bloom’s taxonomy that they involved. Lower-order questions require students to remember or/and have a basic understanding of knowledge. Higher-order questions require students to apply, analyze, or/and evaluate. The phi coefficient was calculated to investigate the relationship between whether questions were case-based and the required level of cognitive processing.ResultsOur results demonstrated that 98.1% of case-based questions required higher-level cognitive processing. Of the non-case-based questions, 33.7% required higher-level cognitive processing. The phi coefficient demonstrated a significant, but moderate correlation between the presence of a patient case in a question and its required level of cognitive processing (phi coefficient= 0.55, P< 0.001).ConclusionMedical instructors should be aware of the association between item format (case-based versus non-case-based) and the cognitive processes they elicit in order to meet the desired balance in a test, taking the learning objectives and the test difficulty into account.

Highlights

It is increasingly accepted that the purpose of assessments is to evaluate what has been learned and to drive students’ learning [1,2]
On the Dutch progress test, students are assessed by case-based questions and non-case-based questions
We investigated to what extent case-based and non-case-based questions followed this assumption based on Bloom’s taxonomy, since this may have implications for how instructors should formulate questions

Summary

Introduction

It is increasingly accepted that the purpose of assessments is to evaluate what has been learned and to drive students’ learning [1,2]. Case-based questions require students to apply, synthesise, and evaluate their knowledge, assessing students’ ability to engage in higher-order cognitive processing. Non-case-based questions are expected to require students to remember and recall their knowledge, assessing students’ lower-order cognitive processing. We investigated to what extent case-based and non-case-based questions followed this assumption based on Bloom’s taxonomy, since this may have implications for how instructors should formulate questions. This may reflect the alignment between the objectives and the quality of the items of the Dutch progress test

Methods

Results

Discussion