Medical students create multiple-choice questions for learning in pathology education: a pilot study

Abstract

BackgroundMedical students facing high-stakes exams want study resources that have a direct relationship with their assessments. At the same time, they need to develop the skills to think analytically about complex clinical problems. Multiple-choice questions (MCQs) are widely used in medical education and can promote surface learning strategies, but creating MCQs requires both in-depth content knowledge and sophisticated analytical thinking. Therefore, we piloted an MCQ-writing task in which students developed MCQs for their peers to answer.MethodsStudents in a fourth-year anatomic pathology course (N = 106) were required to write MCQs using the PeerWise platform. Students created two MCQs for each of four topic areas and the MCQs were answered, rated and commented on by their classmates. Questions were rated for cognitive complexity and a paper-based survey was administered to investigate whether this activity was acceptable, feasible, and whether it promoted desirable learning behaviours in students.ResultsStudents were able to create cognitively challenging MCQs: 313/421 (74%) of the MCQs which we rated required the respondent to apply or analyse pathology knowledge. However, students who responded to the end-of-course questionnaire (N = 62) saw the task as having little educational value. Students found PeerWise easy to use, and indicated that they read widely to prepare questions and monitored the quality of their questions. They did not, however, engage in extensive peer feedback via PeerWise.ConclusionsOur study showed that the MCQ writing task was feasible and engaged students in self-evaluation and synthesising information from a range of sources, but it was not well accepted and did not strongly engage students in peer-learning. Although students were able to create complex MCQs, they found some aspects of the writing process burdensome and tended not to trust the quality of each other’s MCQs. Because of the evidence this task did promote deep learning, it is worth continuing this mode of teaching if the task can be made more acceptable to students.

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

“…Students reported that their appreciation for well-written MCQs grew and their perceived approaches to MCQs were altered as a result of this study, which has not been previously reported. Our finding that students perceived question-writing to benefit their learning stands in contrast to previous reports which suggest that the minority of medical students find question-writing to be beneficial as a learning strategy [16,18,30]. This discrepancy may be explained in part due to the in-depth training medical students received on how to write MCQs in our study, improving understanding and appreciation for the writing process.…”

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

“…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).…”

“…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). We now report three consecutive yearlong case studies of a student-generated MCQ learning exercise that aimed to enhance deep learning and knowledge construction in a 4 th year pathology course and reflect on the lessons learnt.…”

Unique approach to continuing medical education in clinical pharmacology across Australia and New Zealand

“…PeerWise is a free online multiple choice question (MCQ) repository linked to educational institutions that provides a platform for creation, assessment and review of MCQ . Studies conducted in students have suggested that PeerWise may increase academic performance through increased engagement with the writing to learn process . The writing to learn process is thought to increase knowledge through increased content exposure and repetition as well as organisation and self‐evaluation …”

“…8 Studies conducted in students have suggested that PeerWise may increase academic performance through increased engagement with the writing to learn process. 9 The writing to learn process is thought to increase knowledge through increased content exposure and repetition as well as organisation and self-evaluation. 10,11 In addition to the numerous modes of delivery of CME, there are many factors which influence the effectiveness of CME in increasing knowledge and improving physician outcomes.…”