Development Strategies in Medical Education

Introduction: Collective assessment methods in the medical field primarily focus on multiple-choice questions (MCQs) designed to measure the recall of information and basic facts. However, extended matching questions (EMQs), as an advanced type of multiple-choice test, have the capability to assess higher cognitive levels such as problem-solving and the application of knowledge. In this study, aimed at comparing the effectiveness and impact of EMQs and MCQs on the performance and satisfaction of medical students, these two types of assessments were evaluated among students at Mashhad University of Medical Sciences. The results of this study could significantly contribute to improving the quality of assessment in medical education and identifying more effective methods for measuring the clinical abilities of students.
Methods: This research was conducted as a semi-experimental intervention in 2021 on obstetrics and gynecology and internal medicine students at Mashhad University of Medical Sciences. The sample for this study was obtained through convenience sampling, including students in residency, internship, and clerkship programs. A multiple-choice questionnaire (MCQ) was used in the control group, while an extended matching question (EMQ) format was employed in the intervention group. The validity of the test questions was confirmed by a panel consisting of five subject matter experts and one medical education specialist. The collected data were analyzed using SPSS software version 25. To compare the effectiveness of the EMQ and MCQ tests in distinguishing between students at three different educational levels, an analysis of variance (ANOVA) was conducted.
Results: A total of 176 individuals participated, with 87 in the intervention group and 89 in the control group. The baseline variables showed no statistically significant differences between the two groups. The EMQ score (17.1±2.5) was higher than the MCQ score (16.6±2.6), although this difference was not statistically significant. Additionally, student satisfaction with EMQ was greater than with MCQ (17.5 ±2.5 compared to 16.2±3.3). The EMQ test score had a significant inverse correlation with the entrance exam score (r = -0.399, p = 0.011), while this correlation was not observed for the MCQ test (r = -0.258, p = 0.095).
Conclusion: According to learning and educational psychology, monitoring and evaluation are considered the final link in educational activities and complement the teaching process. It is noteworthy that the behavior of some medical students indicates that the method of evaluation can stimulate learning. Therefore, efforts to find the best evaluation method continue. Currently, Multiple Choice Questions (MCQs) are significantly used in medical universities due to their ability to assess a large number of students and evaluate a wide range of educational content with high objectivity. However, most specialists do not recommend this method. The results indicate that student performance and satisfaction in Extended Matching Questions (EMQs) are higher compared to MCQs, which may be due to a more accurate assessment of students and a more objective evaluation of educational content in the extensive matching test.