Abstract
Background: Medical curricula should encourage the development of advanced cognitive skills. Examination questions are an indicator of the cognitive level expected of students. However, it is believed that many factors, such as difficulty in maintaining objectivity in marking, large numbers of scripts and poor language ability of students lead to compiling of essay questions requiring lower cognitive levels. Objectives: The objective of the study was to categorize essay questions of the undergraduate medical program of a Sri Lankan university according to the cognitive level tested. Methods: Essay questions were classified into cognitive levels based on Bloom’s taxonomy and subsequently categorized broadly as those requiring lower order thinking skills (LOTS), middle order thinking skills (MOTS) and higher order thinking skills (HOTS). Analysis was done based on discipline and components of study (pre-clinical, paraclinical and clinical). Results and Discussion: Most questions required LOTS. However, a majority of Physiology questions required HOTS while a majority of questions in the Communication Learning and Research module, Anesthesiology, Gynecology and Obstetrics and Paediatrics required MOTS. Evaluation of questions at pre-clinical, para-clinical and clinical components revealed a focus on questions requiring LOTS at all levels. However, the proportion of questions requiring MOTS increased from pre-clinical to clinical part of the course while the proportion of questions requiring HOTS decreased from the pre-clinical to the clinical part of the course. It is advisable that relevant academic departments reflect upon these findings in view of improving the impact of their examinations on development of higher order cognitive skills among students. Conclusions: Essay questions requiring LOTS predominate in most disciplines and at all levels of the course. An increase in the proportion of questions requiring MOTS and a decline in the proportion of questions requiring HOTS was observed from pre-clinical to the clinical part of the course. Systematic evaluations of examination questions to identify their cognitive levels would generate valid evidence to reflect upon institutional commitments to improve higher order cognitive skills among students.
Highlights
Academic success should be measured not just in terms of what students can remember, but by what students are able to do with their knowledge
Essay questions were classified into cognitive levels based on Bloom‟s taxonomy and subsequently categorized broadly as those requiring lower order thinking skills (LOTS), middle order thinking skills (MOTS) and higher order thinking skills (HOTS)
Systematic evaluations of examination questions to identify their cognitive levels would generate valid evidence to reflect upon institutional commitments to improve higher order cognitive skills among students
Summary
Academic success should be measured not just in terms of what students can remember, but by what students are able to do with their knowledge. Selection of students for this program is by a single highly competitive examination (the advanced level examination). The competitive nature of this examination has led to students and school teachers to resort to educational tactics which do not encourage higher order thinking and are highly teacher dependent. The way of ensuring higher order thinking among medical students would be to develop curricula, which promote such thinking.[4] It may be reasonable to assume that constructing questions which require higher order thinking would reflect the quality of curricula and the institution‟s commitment towards promoting higher order thinking as assessment is known to drive learning.[5] Systematic evaluation of examination questions would provide such institutions with useful evidence to reflect on their educational practices. It is believed that many factors, such as difficulty in maintaining objectivity in marking, large numbers of scripts and poor language ability of students lead to compiling of essay questions requiring lower cognitive levels
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