Abstract
Background and Objective:Multiple Choice Questions (MCQs) can sample broad domains of knowledge efficiently and reliably. The MCQs of lower order C1(Cognitive Level1=Recall of knowledge) do not fulfill this purpose and those of higher cognitive order C2 (Cognitive Level2=Interpret) &C3(Cognitive Level3=Analyze) are better at assessing the problem solving capabilities of the student. Every good educational activity must be supported by quality examination to complete the objectives of a curriculum. The objective of the study was to evaluate MCQs presently being used in internal examinations of medical colleges in Lahore.Methods:Papers consisting of MCQs from Orthopedics other specialties were collected in June 2019 from different medical colleges of Lahore and reviewed by a senior medical teacher without blinding and without his knowing the scores the students had been awarded before. Question statement, clinical scenarios, options and other mistakes were assessed in each item on predetermined criteria. Cognitive level of the item was determined if it was asking for a recall/identify/ analyze response. The results were tabulated and compared in two groups i.e. Miscellaneous and Orthopedics.Results:Most of the items(total=589) in both groups were of C1 cognitive level though Orthopedics (229) were slightly better (χ2 = 49.882 P-Value = 0.000 (Statistically Significant). Miscellaneous group (360) was better in quality in making clinical scenarios (χ2 = 29.952 P-Value = 0.000 (Statistically Significant) and writing a question statement without confusion. Options were better written in both groups. A good percentage of items needed to be corrected for mistakes in spellings, grammar and segregation into under graduate level.Conclusions:The cognitive level of assessment tool s MCQs is quiet low in both groups especially clinical scenario construction can be improved. Mistakes in spellings, grammar and conceptual mediocrity is common in both groups.
Highlights
Most medical colleges teach both the undergraduate & the postgraduate
Students are quick to learn from the assessments methods and adapt their learning techniques to pass the examination which becomes more obvious if the curriculum and assessment are misaligned
Papers consisting of MCQs from Orthopedics and other Specialties (Miscellaneous group) like medicine, surgery, ENT and urology were collected in June 2019 from different medical colleges of Lahore and reviewed by a senior medical teacher without blinding and without knowing the scores the students had been awarded before
Summary
Most medical colleges teach both the undergraduate & the postgraduate. Objective or multiple choice item based papers are an integral part of summative and formative assessments world over[1]. The lower the cognitive level more frequent were the item writing flaws.[2,3,4] Baig et al in their study in 2014 while evaluating basic sciences examination items in Pakistan reported that the cognitive level of most of the SEQs (83.33%) and MCQs (60%) were at C1-recall level, respectively, and 69 Item Writing Flaws (46%) were found in 150 MCQs.[4] A study by Naeem et al, (2012) at Aga Khan University (AKU) and Baig et al (2016) agree that any betterment in item quality is bound to faculty development.[1,4,5] Another study reported 17% change in the quality of MCQs after attending a short training session about the construction of MCQS.[3,4,5] Each teaching activity is planned such as to modify cognitive abilities of learners so that they can analyze the clinical problems, solve them, think critically and interpret findings They can only be made to do this successfully if the assessment does no solicit recall and factual knowledge.[1,6] Educationists insist that the assessment methods should be made known to the students beforehand which has important bearing upon their learning practices and preparation for examinations.[7] All examinations should be followed by a review later so that learning can be further improved. Grammar and conceptual mediocrity is common in both groups
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