Creating assessments as an active learning strategy: what are students’ perceptions? A mixed methods study

Abstract

Background: Teaching students how to create assessments, such as those involving multiplechoice questions (MCQs), has the potential to be a useful active learning strategy. In order to optimize students' learning, it is essential to understand how they engage with such activities. Objective: To explore medical students' perceptions of how completing rigorous MCQ training and subsequently writing MCQs affects their learning. Design: In this mixed methods exploratory qualitative study, eighteen second-year medical students, trained in MCQ-writing best practices, collaboratively generated a question bank. Subsequently, the authors conducted focus groups with eight students to probe impressions of the process and the effect on learning. Responses partially informed a survey consisting of open-ended and Likert rating scale questions that the remaining ten students completed. Focus group and survey data from the eighteen participants were iteratively coded and categorized into themes related to perceptions of training and of collaborative MCQ writing. Results: Medical students felt that training in MCQ construction affected their appreciation for MCQ examinations and their test-taking strategy. They perceived that writing MCQs required more problem-solving and content-integration compared to their preferred study strategies. Specifically, generating plausible distractors required the most critical reasoning to make subtle distinctions between diagnoses and treatments. Additionally, collaborating with other students was beneficial in providing exposure to different learning and questionwriting approaches. Conclusions: Completing MCQ-writing training increases appreciation for MCQ assessments. Writing MCQs requires medical students to make conceptual connections, distinguish between diagnostic and therapeutic options, and learn from colleagues, but requires extensive time and knowledge base.

PeerWise and Pathology: Discontinuing a teaching innovation that did not achieve its potential

“…Furthermore the time taken could suggest that MCQ-writing had a high task complexity for the students and they needed greater instructional support (Leppink and Duvivier, 2016). In an learning activity where medical students wrote MCQs for assessment in small groups, Kurtz et al (2019) reported the task required a high level of content knowledge, and more problem-solving and content-integration than other study methods. Compared to other implementations of MCQ activities, our course requirements may have been too high for the effort required by students.…”

“…MCQ writing for question banks has also been reported as a small group learning activity for medical students, who report this as an enjoyable and useful learning activity (Gooi and Sommerfeld, 2015;Harris et al, 2015;Lawrence, Famokunwa and Ziff, 2016). However MCQ writing may be less efficient than other learning methods (Kurtz et al, 2019) and have high cognitive load for students (Grainger et al, 2018). Our pilot of an MCQ authoring and answering exercise had variable student acceptance (Grainger et al, 2018).…”

Creating assessments as an active learning strategy: too time-consuming for benefit gained?

“…To conclude, as highlighted by Kurtz et al [1], creating assessments, particularly with MCQs, can be beneficial for students' active learning. Students find revising topics through practising questions useful [2] and therefore could benefit further from designing questions.…”

“…The mixed methods study highlighted that students found writing questions a beneficial tool [1]. However, there were concerns that this was time-consuming and, for this reason, students should have maximum benefit from questions they design.…”

“…As question authors have researched their difficult topic in detail, relevant information found should be included alongside answers. Students benefit from collaborative reviews [1] so may appreciate their peers' explanations of problematic areas. As Kurtz et al [1] mentioned, faculty members should review questions and explanations to ensure errors aren't shared.…”