Comparison of multiple choice questions and very short answer type questions to assess different levels of cognition among medical undergraduates

Abstract

Introduction: Very short answer type questions (VSAQs) and multiple choice questions (MCQs) are markedly effective assessment tools for regular formative evaluation at the end of each class. However, their relative efficacy for assessing higher cognitive domain of the students and to prepare them for summative examinations is still inconclusive. Methods: The effectivity of VSAQs and MCQs was analyzed to assess different cognitive levels among 1st-year MBBS students as regular formative assessment tools. Ten MCQs and 10 VSAQs of both average and higher cognitive domains were given at the end of each learning session to all students throughout their first semester for 4 months. At the end of first-semester examination, mean scores for MCQs and VSAQs from both domains were calculated for each student and compared with their semester marks. Results: In comparison to MCQs, students obtained significantly higher marks in VSAQs at both medium and higher cognitive levels. A significant positive association was found between the semester marks and scores of VSAQs irrespective of their cognitive level. On the other hand, students obtaining higher marks in MCQs having higher cognitive levels only showed a positive correlation with their semester scores. Conclusion: For regular end of the class formative assessments, MCQs become efficient tools only when they contain elements of higher cognition with problem-solving approach. Otherwise, students are more comfortable with VSAQs and give a better response with a positive correlation with periodical summative assessments for all cognitive levels.