TY - JOUR
T1 - Progressive clinical case-based multiple-choice questions
T2 - An innovative way to evaluate and rank undergraduate medical students
AU - Cohen Aubart, F.
AU - Lhote, R.
AU - Hertig, A.
AU - Noel, N.
AU - Costedoat-Chalumeau, N.
AU - Cariou, A.
AU - Meyer, G.
AU - Cymbalista, F.
AU - de Prost, N.
AU - Pottier, P.
AU - Joly, L.
AU - Lambotte, O.
AU - Renaud, M. C.
AU - Badoual, C.
AU - Braun, M.
AU - Palombi, O.
AU - Duguet, A.
AU - Roux, D.
N1 - Publisher Copyright:
© 2020 Société Nationale Française de Médecine Interne (SNFMI)
PY - 2021/5/1
Y1 - 2021/5/1
N2 - Introduction: In France, at the end of the sixth year of medical studies, students take a national ranking examination including progressive clinical case-based multiple-choice questions (MCQs). We aimed to evaluate the ability of these MCQs for testing higher-order thinking more than knowledge recall, and to identify their characteristics associated with success and discrimination. Methods: We analysed the 72 progressive clinical cases taken by the students in the years 2016–2019, through an online platform. Results: A total of 72 progressive clinical cases (18 for each of the 4 studied years), corresponding to 1059 questions, were analysed. Most of the clinical cases (n = 43, 60%) had 15 questions. Clinical questions represented 89% of all questions, whereas basic sciences questions accounted for 9%. The most frequent medical subspecialties were internal medicine (n = 90, 8%) and infectious diseases (n = 88, 8%). The most frequent question types concerned therapeutics (26%), exams (19%), diagnosis (14%), and semiology (13%). Level 2 questions (“understand and apply”) accounted for 59% of all questions according to the Bloom's taxonomy. The level of Bloom's taxonomy significantly changed over time with a decreasing number of level 1 questions (“remember”) (P = 0.04). We also analysed the results of the students among 853 questions of training ECNi. Success and discrimination significantly decreased when the number of correct answers increased (P < 0.0001 both). The success, discrimination, mean score, and mean number of discrepancies did not differ according to the diagnosis, exam, imaging, semiology, or therapeutic type of questions. Conclusion: Progressive clinical case-based MCQs represent an innovative way to evaluate undergraduate students.
AB - Introduction: In France, at the end of the sixth year of medical studies, students take a national ranking examination including progressive clinical case-based multiple-choice questions (MCQs). We aimed to evaluate the ability of these MCQs for testing higher-order thinking more than knowledge recall, and to identify their characteristics associated with success and discrimination. Methods: We analysed the 72 progressive clinical cases taken by the students in the years 2016–2019, through an online platform. Results: A total of 72 progressive clinical cases (18 for each of the 4 studied years), corresponding to 1059 questions, were analysed. Most of the clinical cases (n = 43, 60%) had 15 questions. Clinical questions represented 89% of all questions, whereas basic sciences questions accounted for 9%. The most frequent medical subspecialties were internal medicine (n = 90, 8%) and infectious diseases (n = 88, 8%). The most frequent question types concerned therapeutics (26%), exams (19%), diagnosis (14%), and semiology (13%). Level 2 questions (“understand and apply”) accounted for 59% of all questions according to the Bloom's taxonomy. The level of Bloom's taxonomy significantly changed over time with a decreasing number of level 1 questions (“remember”) (P = 0.04). We also analysed the results of the students among 853 questions of training ECNi. Success and discrimination significantly decreased when the number of correct answers increased (P < 0.0001 both). The success, discrimination, mean score, and mean number of discrepancies did not differ according to the diagnosis, exam, imaging, semiology, or therapeutic type of questions. Conclusion: Progressive clinical case-based MCQs represent an innovative way to evaluate undergraduate students.
KW - Discrimination
KW - Docimology
KW - Evaluation
KW - Multiple-choice questions
KW - Progressive clinical cases
UR - http://www.scopus.com/inward/record.url?scp=85100034121&partnerID=8YFLogxK
U2 - 10.1016/j.revmed.2020.11.006
DO - 10.1016/j.revmed.2020.11.006
M3 - Article
C2 - 33518414
AN - SCOPUS:85100034121
SN - 0248-8663
VL - 42
SP - 302
EP - 309
JO - Revue de Medecine Interne
JF - Revue de Medecine Interne
IS - 5
ER -