Bridging Assessment and Clinical Practice: The Added Value of Very Short Answer Questions in Medical Education

Abstract

Multiple-choice questions (MCQs) have long dominated assessment in medical education due to their reliability and ease of grading. However, their reliance on recognition rather than recall can encourage superficial learning and limit evaluation of higher-order cognitive skills such as clinical reasoning. This article explores the potential of very short answer questions (VSAQs) as a more authentic and effective alternative. VSAQs require learners to actively retrieve concise answers, fostering deeper understanding and reducing the influence of guessing or cueing. Recent technological advances have made large-scale implementation feasible, as automated grading now significantly reduces marking time. Moreover, VSAQs provide richer insights into student misconceptions and cognitive processes, offering valuable opportunities for feedback and instructional improvement. While challenges such as question clarity, faculty training, and institutional inertia remain, structured implementation strategies and digital innovations can facilitate adoption. Ultimately, widespread adoption of VSAQs could strengthen medical assessment by bridging the gap between classroom testing and real-world clinical practice. Trial Registration: Not applicable.