Single-choice or multiple true false questions (Kprime):Direct comparison of online tests in pharmacology over one year (Preprint)

Abstract

There remain doubts about whether multiple choice answer formats (single choice) offer the best option to encourage deep learning or whether SC formats simply lead to superficial learning or cramming. Moreover, cueing is always a drawback in the SC format. Another way to assess knowledge is true multiple-choice questions in which one or more answers can be true and the student is not aware of how many true answers are to be anticipated (K´ or Kprime question format).

Here, we compared both single-choice answers (one true answer, SC) with Kprime answers (one to four true answers out of four answers, Kprime) for the very same learning objectives in a study of pharmacology in medical students.

Two groups of medical students were randomly subjected to a formative online test: group A) was first given 15 SC (#1-15) followed by 15 different Kprime questions (#16-30). The opposite design was used for group B.

The mean number of right answers was higher for SC than for Kprime questions in group A (10.02 vs. 8.63, p < 0.05) and group B (9.98 vs. 6.66, p < 0.05). The number of right answers was higher for nine questions of SC compared to Kprime in group A and for eight questions in group B (pairwise T-Test, p < 0.05). Thus, SC is easier to answer than the same learning objectives in pharmacology given as Kprime questions. One year later, four groups were formed from the previous two groups and were again given the same online test but in a different order: the main result was that all students fared better in the second test than in the initial test; however, the gain in points was highest if initially mode B was given.

Kprime is less popular with students being more demanding, but could improve memory of subject matter and thus might be more often used by meidcal educators.