Newble D I, Baxter A, Elmslie R G
Med Educ. 1979 Jul;13(4):263-8. doi: 10.1111/j.1365-2923.1979.tb01511.x.
This paper reports a study which compared the performance of different groups of students and doctors on identical and equivalent tests set in an objective-type format and in a free-response format. The tests were designed to ensure that the content was relevant to clinical practice at the hospital intern level. In all test situations candidates' scores were significantly higher in the objective tests than in the free-response tests. This difference was greater for the more junior and less competent students than for the more competent doctors. The cueing effect of the options was thought to be the main factor responsible for the difference in performance. The results of a questionnaire survey demonstrated that students were aware of the deficiencies in multiple-choice tests. A large majority of the students believed that the free-response tests gave a more accurate assessment of their clinical ability. It was found that in these tests, aimed at measuring aspects of clinical competence, multiple-choice questions appeared to overestimate the candidate's ability to an extent that made them less suitable than free-response questions for this purpose. It was also found that free-response tests, of the type used in this study, provide a suitable alternative to multiple-choice tests for use in the written section of clinical examinations. It was concluded that the written component of the final examination in the medical course should have a preponderance of free-response items over multiple-choice items.
本文报道了一项研究，该研究比较了不同组别的学生和医生在以客观题型和自由回答题型设置的相同及等效测试中的表现。这些测试旨在确保其内容与医院实习医生水平的临床实践相关。在所有测试情况下，客观测试中考生的分数显著高于自由回答测试。对于资历较浅、能力较差的学生来说，这种差异比能力较强的医生更大。选项的提示作用被认为是造成表现差异的主要因素。一项问卷调查结果表明，学生们意识到多项选择题测试存在不足之处。绝大多数学生认为自由回答测试能更准确地评估他们的临床能力。研究发现，在这些旨在衡量临床能力各方面的测试中，多项选择题在一定程度上似乎高估了考生的能力，以至于在这方面不如自由回答题合适。研究还发现，本研究中使用的自由回答测试，可作为多项选择题测试的合适替代方式，用于临床考试的笔试部分。研究得出结论，医学课程期末考试的笔试部分应增加自由回答题的比重，减少多项选择题的比重。
