Evaluation of medical students in radiology. Written testing using uncued multiple-choice questions

RATIONALE AND OBJECTIVES: Evaluation of uncued multiple-choice questions (UMCQ) was compared with traditional multiple-choice questions (MCQ) for assessing medical student performance during radiology electives. Methods for analyzing and improving the quality of UMCQ examinations are described. METHODS: The authors compared the performance of radiology medical students on similarly constructed MCQ and UMCQ tests. For the UMCQ examination, the reliability (coefficient alpha), standard error of measurement, item difficulty index, and corrected item-to-total test coefficient (point biserial correlation) were analyzed. RESULTS: Students' level of performance was lower on UMCQs (mean percent correct score = 68.9 +/- 10.2 standard deviation SD]) than on MCQs (mean percent correct score = 75.6 +/- 12.4 SD). Coefficient alpha for the UMCQ format was .7690 (standard error of measurement mean = 4.89%). Analysis of the item difficulty index and point biserial correlation for each test item provided information for improving the quality of the UMCQ examination. CONCLUSIONS: Because the UMCQ measures students' abilities to recall critical information without providing cues, this format can be used to overcome some of the limitations of conventional MCQs. With simple computerization, analysis of UMCQ testing instruments provides important feedback to both the examinees and the examiner.