Correlation of MCQ subtypes with grading of performance among undergraduate students in a preclinical discipline

Background: Multiple choice questions (MCQs) remain an important tool for objective assessment in medical students wherein different types of MCQs reflect students’ performance towards various aspects of cognitive domain. Thus, all students may not perform with similar ability across all different types of MCQs. In this context, the current study aim to investigate whether performance of medical students in MCQ based assessment relates to the performance in different subtypes of MCQs in Physiology. Methods: Marks obtained in 65 MCQ during formative assessment by 145 first year MBBS students were segregated into four different types of standard MCQs attempted (i.e. Single Response-SRQ, Multiple Response-MRQ, Reason-Assertion-RAQ and Problem based-PBQ) while students were grouped into High, Medium and Low achievers (HA, MA and LA respectively) in relation to their total score. Results: Result showed highest scores in SRQ (69.00±11.6%, 57.34±11.12% and 40.11±13.03%) and PBQ (71.04±11.68%, 59.38±15.36% and 42.35±15.72%) but lowest in MRQ (49.16±11.58%, 41.39±12.42% and 30.78±14.10%) and RAQ (48.82±12.48%, 44.17±14.25% and 31.80±13.05%) for HA, MA and LA respectively with significant differences among all groups. However, total MCQ marks were significantly correlated with MRQ and PBQ for HA; with SRQ and MRQ for MA; and SRQ, MRQ and PBQ for LA. Conclusions: MRQ might have significant influence on the outcome of MCQ based assessment in differentiating between high and medium achievers, whereas both MRQ and PBQ shows potential to differentiate between high and low achieving students. This may be utilized for effective screening in summative assessments or progress of learning in formative assessment.