Husain Syeda Fabeha, Wang Nixi, McIntyre Roger S, Tran Bach X, Nguyen Thao Phuong, Vu Linh Gia, Vu Giang Thu, Ho Roger C, Ho Cyrus S
Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore.
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Front Psychol. 2023 Jun 12;14:1178753. doi: 10.3389/fpsyg.2023.1178753. eCollection 2023.
Traditionally, the effect of assessment item types including true/false questions (TFQs), multiple-choice questions (MCQs), short answer questions (SAQs), and case scenario questions (CSQs) is examined through psychometric qualities or student interviews. However, brain activity while answering such questions or items remains unknown. Functional near-infrared spectroscopy (fNIRS) can be used to safely measure cerebral cortex hemodynamic response during various tasks. Hence, this fNIRS study aimed to determine differences in frontotemporal cortex activity as medical students answered TFQs, MCQs, SAQs, and CSQs.
In total, 24 medical students (13 males and 11 females) were recruited in this study during their mid-psychiatry posting. Oxy-hemoglobin and deoxy-hemoglobin levels in the frontal and temporal regions were measured with a 52-channel fNIRS system. Participants answered 9-18 trials under each of the four types of tasks that were based on their psychiatry curriculum during fNIRS measurements. The area under the oxy-hemoglobin curve (AUC) for each participant and each item type was derived. Repeated measures ANOVA with post-hoc Bonferroni-corrected pairwise comparisons were used to determine differences in oxy-hemoglobin AUC between TFQs, MCQs, SAQs, and CSQs.
Oxy-hemoglobin AUC was highest during the CSQs, followed by SAQs, MCQs, and TFQs in both the frontal and temporal regions. Statistically significant differences between different types of items were observed in oxy-hemoglobin AUC of the frontal region ( ≤ 0.001). Oxy-hemoglobin AUC in the frontal region was significantly higher during the CSQs than TFQ ( = 0.005) and during the SAQ than TFQ ( = 0.025). Although the percentage of correct responses was significantly lower in MCQ than in the other item types, there was no correlation between the percentage of correct response and oxy-hemoglobin AUC in both regions for all four item types ( > 0.05).
CSQs and SAQs elicited greater hemodynamic response than MCQs and TFQs in the prefrontal cortex of medical students. This suggests that more cognitive skills may be required to answer CSQs and SAQs.
传统上，包括是非题（TFQs）、选择题（MCQs）、简答题（SAQs）和病例情景题（CSQs）在内的评估项目类型的效果是通过心理测量学质量或学生访谈来检验的。然而，回答此类问题或项目时的大脑活动情况仍然未知。功能近红外光谱（fNIRS）可用于在各种任务期间安全地测量大脑皮层的血流动力学反应。因此，这项fNIRS研究旨在确定医学生回答是非题、选择题、简答题和病例情景题时额颞叶皮层活动的差异。
本研究共招募了24名医学生（13名男性和11名女性），他们正处于精神病学实习中期。使用52通道fNIRS系统测量额叶和颞叶区域的氧合血红蛋白和脱氧血红蛋白水平。在fNIRS测量期间，参与者根据其精神病学课程在四种类型的任务中的每一种下回答9 - 18次试验。得出每个参与者和每种项目类型的氧合血红蛋白曲线下面积（AUC）。使用重复测量方差分析和事后Bonferroni校正的成对比较来确定是非题、选择题、简答题和病例情景题之间氧合血红蛋白AUC的差异。
在额叶和颞叶区域，病例情景题期间的氧合血红蛋白AUC最高，其次是简答题、选择题和是非题。在额叶区域的氧合血红蛋白AUC中观察到不同类型项目之间存在统计学显著差异（≤0.001）。额叶区域的氧合血红蛋白AUC在病例情景题期间显著高于是非题（= 0.005），在简答题期间显著高于是非题（= 0.025）。尽管选择题的正确回答百分比显著低于其他项目类型，但对于所有四种项目类型，两个区域的正确回答百分比与氧合血红蛋白AUC之间均无相关性（> 0.05）。
病例情景题和简答题在医学生的前额叶皮层中比选择题和是非题引发更大的血流动力学反应。这表明回答病例情景题和简答题可能需要更多的认知技能。
