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Multiple-choice questions are widely used in clinical education. Usually, the students have to mark the one and only correct answer from a set of five alternatives. Here, in a voluntary exam, at the end of an obligatory pharmacology exam, we tested a format where more than one alternative could be correct (N=544 students from three year groups). Moreover, the students were asked to rate each item. The students were unaware how many correct answers were contained in the questions. Finally, a questionnaire had to be filled out about the difficulty of the new tests compared to the one out of five tests. In the obligatory final exam, all groups performed similarly. From the results, we conclude that the new rating scales were a better challenge and could be adapted to assess student knowledge and confidence in more depth than previous multiple-choice questions.

Rating Scale Measures in Multiple-Choice Exams: Pilot Studies in Pharmacology