Multiple-choice Group Research Articles

Hypertensive Emergency Team-Based Learning.

The target audiences for this team-based learning (TBL) activity are resident physicians and medical students. According to the Centers for Disease Control and Prevention (CDC), nearly half of the adults in the United States have hypertension,1 which is a leading cause of cardiovascular disease and premature death.2 In extreme cases, patients may present in hypertensive emergencies, defined as an acute, marked elevation of systolic blood pressure >180mmHg or diastolic blood pressure >120mmHg with evidence of organ dysfunction.3,4 Patients presenting to the emergency department (ED) with symptoms of hypertensive emergencies must be promptly diagnosed and treated to prevent further morbidity and mortality. This TBL utilizes four clinical cases to educate resident physicians and medical students not only on the recognition of hypertensive emergencies, but also on the workup, management, and disposition of patients who present to the ED with hypertension. By the end of this TBL session, learners should be able to: 1) define features of asymptomatic hypertension versus hypertensive emergency, 2) discuss which patients with elevated blood pressure may require further diagnostic workup and intervention, 3) identify a differential diagnosis for patients presenting with elevated blood pressures, 4) recognize the features of different types of end-organ damage, 5) review an algorithm for the pharmacologic management of hypertensive emergencies, 6) indicate dosing and routes of various anti-hypertensive medications, 7) choose the appropriate treatment for a patient who is hypertensive and presenting with flash pulmonary edema, 8) identify an aortic dissection on computed tomography (CT), 9) choose the appropriate treatment for a patient who is hypertensive and presenting with an aortic dissection, 10) identify intracranial hemorrhage on CT, 11) choose the appropriate treatment for a patient who is hypertensive and presenting with an intracranial hemorrhage, and 12) describe the intervention for warfarin reversal. This is a classic TBL that includes an individual readiness assessment test (iRAT), a multiple-choice group readiness assessment test (gRAT), and a group application exercise (GAE). Learners and instructors were given the opportunity to provide verbal feedback after completion of the TBL. Learners included senior medical students and first-, second-, and third-year emergency-medicine residents. Learners were specifically asked if they felt the cases were educational, relevant, and useful to their training. Six resident physicians and three medical students volunteered their verbal feedback, and agreed when they were specifically asked if the cases were educational, relevant, and useful to their training. The same learners also agreed when asked if they felt the TBL was a more enjoyable activity than a direct lecture to refresh their knowledge and skills. One instructor observed that interns and medical students were generally able to reach a correct diagnosis; however, they seemed to struggle more with describing appropriate pharmacologic interventions when compared to more senior learners. Hypertension is a common complaint and incidental finding in patients presenting to the ED. Given its non-specific value, it can be a difficult topic for the novice healthcare provider to master. The differential diagnosis for a patient presenting with hypertension is vast, ranging from benign to emergent, and can sometimes necessitate minimal to substantial workups. Thus, this TBL is a useful, relevant, and effective exercise for residents-in-training to review and understand the management of hypertension. Hypertension, hypertensive emergency, asymptomatic hypertension, flash pulmonary edema, aortic dissection, intracranial hemorrhage, warfarin reversal, team-based learning.

Qualifying with Different Types of Quizzes in an Online EFL course: Influences on Perceived Learning and Academic Achievement

This quasi-experimental study explored how different online exam types differentiate learners’ academic achievement and perceived learning. The participants comprised 95 undergraduate students enrolled in an English course at a Turkish university in three groups, each taking a different type of quiz: with multiple-choice, open-ended, and mixed type questions. The results indicated that the academic achievement of the students in multiple-choice and open-ended groups increased and that quiz results improved the most for the multiple-choice group relative to the other groups. The study found a moderate level of significant relationship between cognitive and affective perceived learning and multiple-choice quiz scores. In addition, the study found a weak level of significant relationship between cognitive and affective perceived learning and mixed-design quiz scores, and between cognitive learning and the academic achievement scores of the mixed-design group. Semi-structured online interviews undertaken to further explain the quantitative data displayed positive influences of the different types of quizzes in terms of study behaviors and satisfaction. The findings of this study are expected to shed light for practitioners aiming to use different online assessment types.

Pediatric Seizure Team-based Learning.

The target audiences for this team-based learning are emergency medicine and emergency medicine-pediatric resident physicians. Pediatric seizure is a common presenting complaint in the emergency department. It is said that over 470,000 children have a diagnosed seizure disorder1 and 2%-5% of children aged 6 months to five years will have a febrile seizure at some point during childhood.2 While there are many published educational materials related to pediatric seizure, they are simulation-based, and/or isolated to management of one underlying diagnosis.3,4,5,6 Therefore, this team-based learning uses four cases to provide an understanding of the possible causes of seizure in children, as well as the management, workup, and disposition for emergency medicine residents in training. By the end of this TBL session, learners should be able to:Define features of simple versus complex febrile seizureDiscuss which patients with seizure may require further diagnostic workupSummarize a discharge discussion for a patient with simple febrile seizuresIdentify a differential diagnosis for pediatric patients presenting with seizureDefine features of status epilepticusReview an algorithm for the pharmacologic management of status epilepticusIndicate medication dosing and routes of various benzodiazepine treatmentsObtain a thorough history in an infant patient with seizures to recognize hyponatremia due to improperly prepared formulaChoose the appropriate treatment for a patient with a hyponatremic seizureDescribe the anatomy of a ventriculoperitoneal (VP) shuntRelate a differential diagnosis of VP shunt malfunctionCompare and contrast the neuroimaging options for a patient with a VP shunt. This team-based learning is a classic TBL because it contains learner responsible content (LRC), an individual readiness assessment test (iRAT), a multiple-choice group RAT (gRAT) with immediate feedback assessment technique (IF/AT), and a group application exercise (GAE). We received formative feedback through conversations with learners afterwards, who stated they enjoyed the activity and felt it was highly useful for their learning; in addition, instructors discussed after the session and made changes accordingly. We collected verbal feedback from instructors and learners after the session. Learners and instructors felt that it was very successful with limited modifications, in particular, the need for more time to complete the activity. Therefore, we suggest a 90 minute rather than 60-minute timeframe to adequately cover all material. Pediatric seizure is a common complaint in the emergency department. It can be a difficult subject for the emergency medicine resident to master based on the variety of presentations. Indeed, the cause, management, and disposition may vary greatly; the etiology may range from benign to life-threatening, sometimes requiring minimal and at other times an extensive workup, with an ultimate disposition of either discharge home or admission to a pediatric intensive care unit. Therefore, team-based learning is well-suited to work through some of the complexities of such cases, and we found this educational session to be highly effective. Pediatric seizure, simple febrile seizure, complex febrile seizure, status epilepticus, hyponatremic seizure, ventriculoperitoneal (VP) shunt, team-based learning.

EFL Learners’ Note Taking: The Effect of Listening Questions and Activities

In this comparative study, an attempt was made to examine the effects of two types of listening questions and activities on the quantity of note taking of intermediate EFL learners. In so doing, the researchers selected a sample of 30 intermediate English language learners randomly assigned to two comparison groups—Multiple-choice Group and True-false Group. The instrument for data collection was note taking papers of students from which the total number of words for each language learner was calculated. Results showed that the True-false Group gained higher scores in note taking quantity as compared with Multiple-choice Group. Based on the results of this study, it is imperative that EFL teachers pay serious attention to the types of activities and questions used in class as they can have an influence on the ways foreign language learners use note taking as a learning strategy.

Dynamic Testing of Analogical Reasoning in 5- to 6-Year-Olds

Multiple-choice (MC) analogy items are often used in cognitive assessment. However, in dynamic testing, where the aim is to provide insight into potential for learning and the learning process, constructed-response (CR) items may be of benefit. This study investigated whether training with CR or MC items leads to differences in the strategy progression and understanding of analogical reasoning in 5- to 6-year-olds ( N = 111). A pretest-training-posttest control group design with randomized blocking was utilized, where two experimental groups were trained according to the graduated prompts method. Results show that both training conditions improved more during dynamic testing compared with untrained controls. As expected, children in the CR condition required more prompting during training and showed different strategy-use patterns compared with the MC group. However, the quality of solution explanations was significantly better for children in the CR condition. It appears that possible performance advantages of training with CR items are most apparent when active processing is required. In the future, we advise including items such as CR or analogy construction in dynamic testing that allow for fine-grained analysis of strategy-use to further discern differences in children’s analogical reasoning understanding.

Weekly quizzes in extended-matching format as a means of monitoring students' progress in gross anatomy

We compared weekly quizzes in extended-matching format with multiple-choice questions and oral examinations as means of monitoring students' progress in gross anatomy. Students' performance on 19 weekly oral examinations or 10-question quizzes based on extended-matching or multiple-choice formats were correlated with their success on 3 interim examinations and the final comprehensive examination. The Kuder-Richardson formula 20, an estimate of precision of the test, was 0.64 for extended-matching quizzes. Students' performance on interim examinations did not differ significantly. There was a significant correlation between students' mean scores on weekly quizzes and mean scores on interim examinations in both the extended-matching (r = 0.516) and multiple-choice group (r = 0.823). The mean grades (ranging from 2 to 5) on the final exam, based on understanding of anatomical concepts and their application in clinical practice, were significantly higher in extended-matching group (4.8) than in the multiple-choice (4.1) and orally examined groups (3.9) (p < 0.05). We conclude that extended-matching quizzes were at least as effective as multiple-choice quizzes and oral examinations and may be better for acquiring synthetic understanding of anatomical concepts especially in combination with other means of knowledge assessment. We recommend them as a reliable and objective means of monitoring students' performance during a gross anatomy course.

Success in college for students with discrepancies between performance on multiple-choice and essay tests.

Students with high scores (top third) on the essay portion of an Advanced Placement examination and low scores (bottom third) on the multiple-choice portion of the examination were compared with students with the opposite pattern (top third on the multiple-choice questions and bottom third on the essay questions). Across examinations in different subject areas (history, English, and biology), students who were relatively strong in the essay format and weak in the multiple-choice format were as successful in their college courses as students with the opposite pattern, especially in those courses where grades are typically not determined by multiple-choice tests. Although differential essay and multiple-choice test performance was not related to course grades, it was related to performance on other tests. Students in the high multiple-choice/low essay group performed much better than the other group on other multiple-choice tests, especially the verbal section of the SAT. In relation to their performance on multiple-choice tests, students in the high essay/low multiple-choice group performed well on other essay tests.

Simulation of psychosis on a multiple-choice projective test.

The ability of a new multiple-choice group Rorschach instrument to differentiate 62 undergraduate students asked to simulate psychosis from 75 students and 55 schizophrenics given standard instructions was investigated. For each of 50 responses to miniature inkblots, normals and psychotics chose one of four alternative answers as most descriptive of what the stimulus looked like. Simulators responded as they thought a psychotic or insane person would. As hypothesized, simulators chose significantly more "good form but bizarre wording" responses than normals or psychotics, suggesting that the test is promising as a practical clinical indicator of attempts to simulate psychosis.

Relationship of Two Measures of Conformity

The intent of the present research was to study the Popular ( P ) response as measured by the Harrower (1943) Multiple-choice Group Rorschach Test in relationship to Scale M of the Cattell ( 1964) Sixteen Personality Factor Test Questionnaire (16 PF). The P response and Scale M generally have been assumed to measure an individual's degree of conformity. The question of whether there is any relationship between the Multiple-choice Group Rorschach Test and the 16 PF concerning the variable of conformity has not been explored. Accordingly the present investigation measured the relationship of the two instruments for assessing conformity. Both instruments describe the conforming person somewhat differently but suggest that high scores are expressive of the social stereotype of compliance with the conventional. Undergraduates, 64 males and 36 females from three classes of introductory psychology, were tested using Scale M of the 16 PF, Form B, and the Harrower Multiple-choice Group Rorschach Test. Pearson correlation coefficients were computed for the two measures for total group, males, and females. The respective correlation coefficients were -.04, .07, and -.19; for each group the correlation coefficient was nonsignificant. The mean stanine scores for Scale M and the P response for each of the three groups were: total data, 6.51 and 5.25; males, 6.78 and 5.14; females, 6.08 and 5.47, respectively. The range of the scores for Scale M was 1 to 10 and for the P response, 3 to 9. The data were analyzed for possible relationships by calculating chi squares after dividing the data at the midpoint of the Scale M scores and the P responses and using only the extremes. The chi squares for the males, the females, and the rotal group did not approach significance ( 9 < .05, one tail, in the expected direction). These data support the notion that there is no agreement between the two scores as measures of conformity. Caution is required in drawing conclusions because the research is exploratory and heuristic. The utility of these findings, however, appears worthy of further investigation.

Studies in projective techniques: I. The reliability of a multiple choice group Rorschach test.

Studies in projective techniques: I. The reliability of a multiple choice group Rorschach test.

The Validity of the Multiple Choice Group Rorschach test in the Screening of Naval Personnel

The Validity of the Multiple Choice Group Rorschach test in the Screening of Naval Personnel

The Multiple Choice Group Rorschach Test as a Means of Screening Applicants for Jobs

The Multiple Choice Group Rorschach Test as a Means of Screening Applicants for Jobs

The Use of the Multiple Choice Group Rorschach Test in Military Screening

The Use of the Multiple Choice Group Rorschach Test in Military Screening