Analysis of testing with multiple choice versus open-ended questions: Outcome-based observations in an anatomy course

The pedagogical approach for both didactic and laboratory teaching of anatomy has changed in the last 25 years and continues to evolve; however, assessment of student anatomical knowledge has not changed despite the awareness of Bloom's taxonomy. For economic reasons most schools rely on multiple choice questions (MCQ) that test knowledge mastered while competences such as critical thinking and skill development are not typically assessed. In contrast, open-ended question (OEQ) examinations demand knowledge construction and a higher order of thinking, but more time is required from the faculty to score the constructed responses. This study compares performances on MCQ and OEQ examinations administered to a small group of incoming first year medical students in a preparatory (enrichment) anatomy course that covered the thorax and abdomen. In the thorax module, the OEQ examination score was lower than the MCQ examination score; however, in the abdomen module, the OEQ examination score improved compared to the thorax OEQ score. Many students attributed their improved performance to a change from simple memorization (superficial learning) for cued responses to conceptual understanding (deeper learning) for constructed responses. The results support the view that assessment with OEQs, which requires in depth knowledge, would result in student better performance in the examination. Anat Sci Educ 11: 254–261.