THE VIRTUES OF EXTENDED MATCHING AND UNCUED TESTS AS ALTERNATIVES TO MULTIPLE-CHOICE QUESTIONS

The objectives of this study were to compare the reliability and valid ity of written test formats that are widely used in medical education (multiple choice, uncued, extended matching, and true/false) and evalu ate the effects of uncued examinations on long-term retention of medic al knowledge. Uncued tests were introduced into a traditional course i n general and systemic pathology (six interim tests). In the following year, students were given eight tests written in the four formats, ea ch being used twice. The academic achievement of students in these 2 y ears was compared with that of students in 2 previous years, in which multiple choice tests tc ere used. Measures of academic achievement in cluded performance on a final comprehensive examination and the United States Medical Licensing Examination (USMLE). Student performance on uncued tests was consistent over time tie, there was no learning curve ). Mean scores ranged from 77% to 84%, and coefficient alpha reliabili ty estimates on 100-item tests were excellent (0.79 to 0.90). Extended matching tests were also reliable, with a mean coefficient alpha of 0 .90. There was no significant relationship between test format and stu dent performance on subsequent comprehensive examinations. Our results indicate that extended matching and uncued tests have considerable ad vantages over multiple choice and true/false examinations. They are mo re reliable, better able to discriminate the well-prepared from the ma rginal student, and well suited for testing core knowledge. Contrary t o our expectation, extended matching questions with 20 choices present ed to the student were as statistically reliable and valid as uncued q ueries with several hundred choices. Copyright (C) 1997 by W.B. Saunde rs Company.