Abstract
BackgroundSingle Best Answer (SBA) questions are widely used in undergraduate and postgraduate medical examinations. Selection of the correct answer in SBA questions may be subject to cueing and therefore might not test the student’s knowledge. In contrast to this artificial construct, doctors are ultimately required to perform in a real-life setting that does not offer a list of choices. This professional competence can be tested using Short Answer Questions (SAQs), where the student writes the correct answer without prompting from the question. However, SAQs cannot easily be machine marked and are therefore not feasible as an instrument for testing a representative sample of the curriculum for a large number of candidates. We hypothesised that a novel assessment instrument consisting of very short answer (VSA) questions is a superior test of knowledge than assessment by SBA.MethodsWe conducted a prospective pilot study on one cohort of 266 medical students sitting a formative examination. All students were assessed by both a novel assessment instrument consisting of VSAs and by SBA questions. Both instruments tested the same knowledge base. Using the filter function of Microsoft Excel, the range of answers provided for each VSA question was reviewed and correct answers accepted in less than two minutes. Examination results were compared between the two methods of assessment.ResultsStudents scored more highly in all fifteen SBA questions than in the VSA question format, despite both examinations requiring the same knowledge base.ConclusionsValid assessment of undergraduate and postgraduate knowledge can be improved by the use of VSA questions. Such an approach will test nascent physician ability rather than ability to pass exams.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0793-z) contains supplementary material, which is available to authorized users.
Highlights
Single Best Answer (SBA) questions are widely used in undergraduate and postgraduate medical examinations
In order to address the shortcomings that we have identified in this model, we have developed a novel, machine marked examination in which students give a very short answer (VSA) which typically consists of three words or less
The high scoring of the SBA questions in comparison to the VSA format is a cause for concern for those involved in the training of fit for purpose doctors of tomorrow
Summary
Single Best Answer (SBA) questions are widely used in undergraduate and postgraduate medical examinations. Selection of the correct answer in SBA questions may be subject to cueing and might not test the student’s knowledge In contrast to this artificial construct, doctors are required to perform in a real-life setting that does not offer a list of choices. SBA questions have become increasingly popular because they can test a wide range of topics with high reliability and are the ideal format for machine marking. They have a definitive correct answer which is not subject to interpretation on the part of the examiner. At the end of the history and physical examination, the doctor has to formulate a diagnosis and management plan based on information gathered
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