Plus ça change, plus c’est pareil: Making a continued case for the use of MCQs in medical education

Abstract

Despite the increased emphasis on the use of workplace-based assessment in competency-based education models, there is still an important role for the use of multiple choice questions (MCQs) in the assessment of health professionals. The challenge, however, is to ensure that MCQs are developed in a way to allow educators to derive meaningful information about examinees’ abilities. As educators’ needs for high-quality test items have evolved so has our approach to developing MCQs. This evolution has been reflected in a number of ways including: the use of different stimulus formats; the creation of novel response formats; the development of new approaches to problem conceptualization; and the incorporation of technology. The purpose of this narrative review is to provide the reader with an overview of how our understanding of the use of MCQs in the assessment of health professionals has evolved to better measure clinical reasoning and to improve both efficiency and item quality.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Notes on contributors

Debra Pugh

Debra Pugh, MD, FRCPC, MHPE, is Vice Chair of the Central Examination Committee at the Medical Council of Canada and Associate Professor, Department of Medicine, at the University of Ottawa; Ottawa, ON, Canada.

André De Champlain

André De Champlain, PhD, is the Director of Psychometrics and Assessment Services at the Medical Council of Canada; Ottawa, ON, Canada.

Claire Touchie

Claire Touchie, MD, FRCPC, MHPE, is Chief Medical Education Officer at the Medical Council of Canada and Associate Professor, Department of Medicine, at the University of Ottawa; Ottawa ON, Canada.