Dear Editor,
The recent paper by Xiromeriti et al. in Medical Science Educator [1] highlighted the importance of developing higher-order multiple-choice questions (MCQs) to test higher-order learning. It brings about the question—if such MCQs are to be used as assessment tools, then should they also be made readily available as a study resource to students for exam practice?
In this current era, more medical students are turning to online MCQ question banks to study in favour of more traditional resources—a 2015 study of Australian medical students found that online question banks were a more popular tool for revision and learning new information, compared with textbooks [2]. Student-reported advantages of MCQs as a revision resource, compared with more traditional resources, are that their interactivity ‘staves off boredom’ and that in-built mechanisms that reward progression through questions motivate learners to continue [3]. An identified pitfall of current MCQ banks as a revision resource is that repetition of these MCQs may lead students to eventually be able to recognise the correct answer without any deeper understanding [2]; however, the utilisation of higher-order MCQs, written as per Xiromeriti et al.’s guidance, should help to mitigate this. Further research is needed to establish what types of study resources best prepare students for assessments with higher-order MCQs.
The authors aim to partially replace asynchronous written coursework such as essays with these higher-order MCQs, which also means that the marking process will be more standardised, less subjective, quicker, and more cost-effective in comparison to essay-based assessments [4]. Essay-based assessments either require expert markers or a comprehensive marking template which subsequently leads authors to write lower-order questions as these can be more easily marked a strict template, rather than higher-order questions requiring synthesis and analysis [5]. However, essay-based assessments do pose a key benefit—they uniquely allow examiners to view a trace of students’ thought processes which is particularly valuable in identifying misconceptions and facilitates more valuable feedback [4] to aid student learning.
Ultimately, it is essential to obtain students’ viewpoints on whether they feel higher-order MCQ assessments reflect the effort they have invested into studying and their knowledge because for an assessment system to considered valid students must also regard it as acceptable [6].
Declarations
Conflict of Interest
The author declares no competing interests.
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References
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