Dangprapai Yodying, Ngamskulrungroj Popchai, Senawong Sansnee, Ungprasert Patompong, Harun Azian
Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
J Microbiol Biol Educ. 2020 Feb 28;21(1). doi: 10.1128/jmbe.v21i1.1773. eCollection 2020.
During the preclinical years, single-best-answer multiple-choice questions (SBA-MCQs) are often used to test the higher-order cognitive processes of medical students (such as application and analysis) while simultaneously assessing lower-order processes (like knowledge and comprehension). Consequently, it can be difficult to pinpoint which learning outcome has been achieved or needs improvement. We developed a new scoring system for SBA-MCQs using a step-by-step methodology to evaluate each learning outcome independently. Enrolled in this study were third-year medical students ( = 316) who had registered in the basic microbiology course at the Faculty of Medicine, Siriraj Hospital, Mahidol University during the academic year 2017. A step-by-step SBA-MCQ with a new scoring system was created and used as a tool to evaluate the validity of the traditional SBA-MCQs that assess two separate outcomes simultaneously. The scores for the two methods, in percentages, were compared using two different questions (SBA-MCQ1 and SBA-MCQ2). SBA-MCQ1 tested the students' knowledge of the causative agent of a specific infectious disease and the basic characteristics of the microorganism, while SBA-MCQ2 tested their knowledge of the causative agent of a specific infectious disease and the pathogenic mechanism of the microorganism. The mean score obtained with the traditional SBA-MCQs was significantly lower than that obtained with the step-by-step SBA-MCQs (85.9% for the traditional approach versus 90.9% for step-by-step SBA-MCQ1; < 0.001; and 81.5% for the traditional system versus 87.4% for step-by-step SBA-MCQ2; < 0.001). Moreover, 65.8% and 87.8% of the students scored lower with the traditional SBA-MCQ1 and the traditional SBA-MCQ2, respectively, than with the corresponding sets of step-by-step SBA-MCQ questions. These results suggest that traditional SBA-MCQ scores need to be interpreted with caution because they have the potential to underestimate the learning achievement of students. Therefore, the step-by-step SBA-MCQ is preferable to the traditional SBA-MCQs and is recommended for use in examinations during the preclinical years.
在临床前阶段，单项最佳答案选择题（SBA-MCQs）常被用于测试医学生的高阶认知过程（如应用和分析），同时评估低阶认知过程（如知识和理解）。因此，很难确定学生实现了哪种学习成果或需要改进的方面。我们使用逐步评估的方法为SBA-MCQs开发了一种新的评分系统，以独立评估每个学习成果。本研究纳入了2017学年在玛希隆大学诗里拉吉医院医学院注册基础微生物学课程的三年级医学生（n = 316）。创建了一个采用新评分系统的逐步SBA-MCQ，并将其用作评估传统SBA-MCQs有效性的工具，传统SBA-MCQs同时评估两个不同的结果。使用两道不同的题目（SBA-MCQ1和SBA-MCQ2）比较了两种方法的得分百分比。SBA-MCQ1测试学生对特定传染病病原体及该微生物基本特征的知识，而SBA-MCQ2测试学生对特定传染病病原体及该微生物致病机制的知识。传统SBA-MCQs的平均得分显著低于逐步SBA-MCQs的得分（传统方法为85.9%，逐步SBA-MCQ1为90.9%；P < 0.001；传统系统为81.5%，逐步SBA-MCQ2为87.4%；P < 0.001）。此外，分别有65.8%和87.8%的学生在传统SBA-MCQ1和传统SBA-MCQ2中的得分低于相应的逐步SBA-MCQ题目组。这些结果表明，传统SBA-MCQ的分数需要谨慎解读，因为它们有可能低估学生的学习成果。因此，逐步SBA-MCQ比传统SBA-MCQ更可取，建议在临床前阶段的考试中使用。
