Imprecise terms in UK medical multiple-choice questions: what examiners think they mean.

Many multiple-choice questions (MCQs) used in medical education in the UK contain undefined, imprecise terms. They are particularly common in true/false items and can be found in classroom tests, published examples of MCQs and, more importantly, in high-stakes examinations which determine a candidate's graduation or membership of a professional body. This study investigated imprecise terms used in some MB BS final examinations and the Part 1 Membership Examination of the Royal College of Physicians. It revealed that imprecise terms occur commonly, yet there is a wide range of opinion among the examiners themselves about their meanings. The numbers and variety of imprecise terms which were found in high-stakes MCQ examinations are described in this paper and details are given concerning the lack of consensus about their meanings as reported by the responsible examiners. A second type of construction error--disproportionately large numbers of 'true' branches--was also recorded. Exemplary practices do exist in MCQ quality assurance, but in the UK they are very much the exception rather than the rule. The findings of this investigation strongly indicate a need for change.

An innovation in the assessment of future dentists.

'The assessment of students is a serious and often tragic enterprise.' The central question in assessment is 'What is one trying to assess?'. Is it factual knowledge, ability to apply and problem solve, clinical competencies or indeed other attributes? The domain being assessed requires appropriate methods. Professionals involved in examination development have identified three characteristics which all assessment methods demand: reliability, validity and feasibility. This article sets out to describe these features.

Four years' experience of an undergraduate medical nutrition course.

In 1992 the medical colleges of The Royal London and St Bartholomew's hospitals launched a new curriculum in which basic medical sciences were to be integrated with early exposure to clinical medicine in the first phase. The curriculum was to be modular and integrative, combining clinical and medical-science-based teaching of body systems, rather than the traditional teaching by departmental discipline. We describe the inception, content and evaluation of a 7-day course on nutrition which was developed as part of this curriculum. It was rated highly by the students, whose feedback led to important modifications. The programme works well in practice, and could provide a useful guide for other schools about to set up nutrition courses for medical students.

Guide to postgraduate exams: multiple-choice questions.

Multiple-choice questions are among the most common components of medical exams. They are potentially very reliable and are easy and accurate to mark. Their validity leaves much to be desired, however, and the common practice of negative marking is ill considered.

Guide to postgraduate exams: how to prepare.

Ways in which doctors might learn, revise and prepare for postgraduate exams are outlined in this article. Some educational principles are described to explain why understanding is far more useful and permanent than rote-learning. Suggestions are also made about exam technique.

Guide to postgraduate exams: Royal College exams.

Postgraduate exams are important milestones (or barriers) in specialist careers. However, there are several peculiar features in the Royal Colleges' exams, and considerable differences between them. This is the first of three articles aimed at helping candidates make appropriate preparations.