Comparison of the level of cognitive processing between case based items and non case based items on the Interuniversity Progress Test of Medicine in the Netherlands
Purpose It is assumed that case based questions require higher order cognitive processing, whereas questions that are not case based require lower order cognitive processing. In this study, we investigated to what extent case based and non case based questions followed this assumption based on Bloom's taxonomy. Methods In this article, 4,800 questions from the Interuniversity Progress Test of Medicine were classified based on whether they were case based and on the level of Bloom's taxonomy that they involved. Lower order questions require students to remember or/and have a basic understanding of knowledge. Higher order questions require students to apply, analyze, or/and evaluate. The phi coefficient was calculated to investigate the relationship between whether questions were case based and the required level of cognitive processing. Results Our results demonstrated that 98.1% of case based questions required higher level cognitive processing. Of the non case based questions, 33.7% required higher level cognitive processing. The phi coefficient demonstrated a significant, but moderate correlation between the presence of a patient case in a question and its required level of cognitive processing (phi coefficient= 0.55, P< 0.001) Conclusion Medical instructors should be aware of the association between item format (case based versus non case based) and the cognitive processes they elicit in order to meet the desired balance in a test, taking the learning objectives and the test difficulty into account.
Journal of educational evaluation for health professions