The Utility of Multiple-Choice Assessment in Current Medical Education: A Critical Review

Abstract

In recent years, healthcare education providers have boasted about a conscious shift towards increasing clinical competence via assessment tests that promote more active learning. Despite this, multiple-choice questions remain amongst the most prevalent forms of assessment. Various literature justifies the use of multiple-choice testing by its high levels of validity and reliability. Education providers also benefit from requiring fewer resources and costs in the development of questions and easier adaptivity of questions to compensate for neurodiversity. However, when testing these (and other) variables via a structured approach in terms of their utility, it is elucidated that these advantages are largely dependent on the quality of the questions that are written, the level of clinical competence that is to be attained by learners and the impact of negating confounding variables such as differential attainment. Attempts at improving the utility of multiple-choice question testing in modern healthcare curricula are discussed in this review, as well as the impact of these modifications on performance.