A comparison of multiple‐choice tests and free‐response tests in examinations of clinical competence

This paper reports a study which compared the performance of different groups of students and doctors on identical and equivalent tests set in an objective‐type format and in a free‐response format. The tests were designed to ensure that the content was relevant to clinical practice at the hospital intern level. In all test situations candidates’ scores were significantly higher in the objective tests than in the free‐response tests. This difference was greater for the more junior and less competent students than for the more competent doctors. The cueing effect of the options was thought to be the main factor responsible for the difference in performance.

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