Objective: To classify the cognitive skills required to answer modified essay questions (MEQs) and to assess the performance of the fifth-year medical students in answering the MEQs.
Material and Methods: The MEQs for the block "Health and diseases from conception to adolescence", academic year 2002, were retrospectively studied. Each MEQ item was categorized into 7 cognitive skills: data gathering, hypothesis generation, investigation and interpretation, hypothesis refinement and assessment, management, patient education, and basic clinical science.
Results: The total fifth-year enrolment consisted of 125 students. They were divided into 4 groups, and each group had 5 MEQs. Three MEQs were repeated, thus the overall number of unique MEQs for the year was 17. When classifying the cognitive skills required to answer MEQs, data gathering was found to be the highest proportion with 27.8% of the total theoretical score, followed by management at 17.4%, hypothesis refinement and assessment 16.9%, investigation and interpretation 13.4% and hypothesis generation 12.9%. The reliability coefficients of the MEQs ranged from 0.52-0.72. When the cognitive skills of the 4 groups of students were analyzed separately, significant differences were found. The cognitive skill on which the students showed the highest mean score was hypothesis generation and the lowest were management and patient education.
Conclusion: The overall MEQ analysis has shown the difference in proportions of cognitive skills between groups of students. The proportion of hypothesis generation and hypothesis refinement and assessment were quite low in consideration of the learning objectives. Thus, the MEQ needs to be improved by developing tables of specifications for each MEQ. The student weaknesses also need to be improved.