Testing at the medical student level is performed on knowledge and application of general principles based upon real problems in patient care situations, or real scientific models that serve as the basis for our understanding of health care. Therefore, focus on content that emphasizes:
Normal function of the human body
Common problems and their underlying concepts
Serious problems with importance to the patient
Examples of mechanisms for disease
Faculty should realize that assessments drive the curriculum, with a 'trickle down' effect to students who try to perceive what is important to learn. For medical practice, then, learning objectives with assessments should focus on:
Question Structural Components
Recall: requires memorization of facts.
Visual interpretation: tabular or graphic information is given.
Synthesis: recognize the connections among the data.
Problem solving: analyze the data to recognize a situation or general principle and then make a diagnosis, identify relationships, or select a course of action.
Lower taxonomic level: employ rote memorization with simple recall of facts, typically for a single content area. Few if any questions in medical practice are at this level.
Higher taxonomic level: use your knowledge base through problem solving, applied to a clinical vignette or experimental format covering content of multiple disciplines. Students who understand the underlying concepts and who recognize clinical scenarios do better. Almost all questions in medical practice are at this level.
The standard elements include:
Multiple choice, single best answer format
5 or more foils per question
Construction to apply problem-solving
Integration across subject areas
Lead-in statement with the "most likely" choice
The standard question styles:
Clinical vignette: focus on a single patient with information to interpret
Experimental: focus on data to interpret that illustrate a scientific principle applicable to normal or disease states