Abstract
Single best answers (single choice, SC) are the classical tools used in medical examinations on all levels of education. In contrast, very short answer (VSA) probably requires sound prior knowledge and deeper learning than SC, and VSA should make cueing and guessing impossible. Hence, in a basic pharmacology course, we wanted to compare the SC and VSA formats directly at the end of the course and one year later. Medical students (n = 211) were given a formative online test. Two groups were randomly formed (A and B). Participants in group A were first given fifteen single choices (one out of five) pharmacology questions and thereafter fifteen very short answer questions (open question which were to be answered online and semiautomatically assessed). Very similar questions with regard to learning objectives but in opposite order were given to group B. After one year, about half of students from group A were again given the very same questions (AA) or the opposite questions (AB). Likewise, group B was again tested with the opposite questions (BA) or the same (BB). The SC questions in groups A, AA, AB, B, BA, and BB were in sum easier to answer than the corresponding VSA questions. Repeating the test after one year with the same students increased retention of right answers by about 1.5 points. In summary, direct comparison questions in the VSA format are more difficult for our students to answer than questions in the SC format, conceivably because cueing and guessing are eliminated. Knowledge retention is present by repeating the very same examination format online. Retention of knowledge is higher when starting with VSA (group B) both for a subsequent SC format or a VSA format. These data would argue for more use of the VSA format at least in pharmacology examinations.
Highlights
Single best answers are the classical tools used in medical examination on all levels
Education Research International one has argued that very short answer (VSA) is faster and easier to write for the medical educators than Single choice (SC) formats [5, 6]. eoretically, SC offers retrieval cues, the right answer is given as an option, and success of the test taker depends as much on familiarity with the content as on active memory retrieval [7]. ey have shown using a short biology text in psychology students that VSA requires text processing and really understanding the new given text, whereas SC could be answered mainly based on prior biology high school knowledge [7]. ere is the assumption that VSA in a formative test should drive students to deep learning, whereas SC would lead more to superficial or strategical learning [8]
Our research questions (QR) were as follows: QR1, Is the SC format always easier for students than the VSA in basic pharmacology items? QR 2, Does the VSA format offers a better preparation for subsequent VSA as well as for the SC format in basic pharmacology? Preliminary results of this study have been published in abstract form [15]
Summary
Single best answers (single choice, SC, generally called selective response formats cf. [1]) are the classical tools used in medical examination on all levels. Poor distractors make guessing and cueing even easier such that up to 50% of the right answers can be guessed Another way to assess knowledge is an essay (generally called constructed response format cf [1]). Others had tested clinical diagnosis in family medicine comparing SC and VSA (long list of possible answers was provided, uncued questions: abbreviated UnQ) but on paper sheets [3]. They reported a high correlation for the same topic in results of both formats: SC and UnQ. Our research questions (QR) were as follows: QR1, Is the SC format always easier for students than the VSA in basic pharmacology items? QR 2, Does the VSA format offers a better preparation for subsequent VSA as well as for the SC format in basic pharmacology? Preliminary results of this study have been published in abstract form [15]
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