Analysis of Physiology Theory Question Papers for Competency-Based Medical Education Implementation in Gujarat: A Pilot Study.

Introduction Theory question papers form an important part of assessment in medical education. As per the Competency-Based Medical Education (CBME) guidelines 2019, questions should test higher levels of cognition. This pilot study analyzes 60 question papers from different universities in Gujarat for their construct and content validity. The aim was to analyze the quality of physiology question papers from various medical universities in Gujarat to gain insights into assessment quality and its alignment with the CBME guidelines. The objectives were twofold: to evaluate the "construct validity" and "content validity" of these physiology theory question papers over the past three years according to the CBME standards. Methods An observational study using a cross-sectional records-based approach was carried out, evaluating 60 summative exam question papers in physiology from eight different universities of Gujarat for their construct and content validity. Using Bloom's taxonomy, the learning level of the cognitive domain for the questions asked was assessed. The findings compared and displayed a sample of papers. Results A total of 1842 questions were analyzed from the 60 question papers of eight different universities of the Gujarat state. The study found that the questions asked for different levels of cognition in Bloom's taxonomy, i.e., remember, understand, apply, analyze, evaluate, and create, were 560 (30.40%), 434 (23.26%), 222 (12.05%), 118 (6.41%), 94 (5.10%), and 0.00%, respectively. A total of 414 (22.48%) questions did not have any verb, so they did not fit into any level of Bloom's taxonomy. The majority of questions (1773, 96.25%) were asked from the core competencies, while a small percentage (69, 3.75%) of questions were asked from the non-core competencies of physiology. Conclusion The majority of questions in the summative question papers in physiology were of level "remember" and "understand" as per Bloom's taxonomy. Of the questions, 26% did not have any verb. There is a need to incorporate more questions testing higher levels of cognition and to use blueprints by universities. Faculty training is also necessary to bring about course correction.