29 Written and computer-based assessment
The elements in written assessment
The stimulus
The stimulus for the learner’s response may be:
• a short statement or question, e.g. ‘In which of the following pathologies does a patient typically present with weight loss and an increased appetite?’ or ‘List the 3 options in the management of a patient with hyperthyroidism.’
• a statement or question with accompanying diagrams or charts, e.g. ‘In the diagram which structure is labelled ‘A’?’
• a short clinical scenario with a patient’s presentation followed by a question, e.g. ‘Mrs Wilkie, a 35-year-old waitress complaining of tiredness and nervousness… ’
• a more extended patient management problem that develops over a period of time.
The student’s response
The response expected of the learner can be categorised into:
• Constructed response questions where the student has to write a long or short narrative in response to the stimulus. These include essays, short essay questions and short answer questions.
• Selected response questions where the student has to make a selection from a range of options provided. These include multiple choice questions (MCQs), for example the one best answer or multiple true/false questions and extended matching items.
The assessment of the student’s response
The learner’s response may be scored:
• Automatically correct or incorrect, as in an MCQ where there is an agreed correct answer. This also applies to short answer questions where the expected answer is limited to a few words. In this case, agreement has to be reached with regard to alternative wording and spelling that is acceptable.
• In a constructed response question, by an examiner based on a holistic impression of the student’s response, or with an assigned structured marking scheme.
• In the context of the answers to the questions provided by members of a panel of experts. This is the strategy used in the script concordance test as described below.
Standard setting
The subject of standard setting was introduced in the previous chapter. A range of methods have been used in a written examination to determine the mark above which students will pass the examination and below which they will fail (Bandaranayake 2008).