This document discusses the importance of having a relevant and robust evaluation process for students. It outlines the key attributes of a good modified essay question (MEQ), including reliability, validity, objectivity, relevance, and feasibility. The document provides guidance on designing, constructing, and writing good test questions for MEQs. Specifically, it explains how MEQs present a clinical scenario followed by a series of short answer and justification questions to assess higher cognitive functions like problem solving and decision making. Overall, the document aims to help improve the quality of MEQs by sharing best practices for their creation and administration.

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HAVE WE MOVED ON ????
DO WE NOW HAVE A RELEVANT & ROBUST EVALUATION PROCESS ?

2. Attributes of A Good MEQ
PROF DR RIPTINDER SINGH
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3. ENIGMA OF EVALUTION 3

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5. MATRIX OF EVALUATION
 Reliability – Consistency of results
 Validity - Truly assess what is meant to
 Objectivity – concordance between the
examiners/faculty
 Relevance - Appropriateness
 Feasibility – Ease of implementation
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6. DESIGNING OF A TEST QUESTION
 PLANNING - Is this type of question suitable to assess the
objective ?
 PREPARATION – TOPIC -Does it match the Learning
Objective ?
What CONTENT of the topic it is testing ?
Writing of the ITEMS
BLUEPRINTING - How much is each objective worth in
WEIGHTAGE & NUMBER OF ITEMS ?
MARKING AND TIME PLAN - Are the marks and time
allotted adequate ?
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7. Modified Essay Question
 A Modified Essay Question is one of the various types of Essay
Questions used to evaluate the students
 An MEQ is structured to test a specific aspect of a subject matter
by assessing the response of the examinee to a specific
condition/case scenario.
 Assesses the student in
 Clinical Appraisal
 Problem solving HIGHER COGNITIVE FUNCTIONS
 Decision making
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8. SEQ and MEQ
Traditional essay
Describe the diagnosis and management of Thyrotoxicosis
(15
marks)
SEQ
1.a) Describe the symptoms and signs of thyrotoxicosis
(5
marks)
b) Outline the investigations (5 marks)
c) What are the various modes of treatment? (5marks)
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10. Evolution of MEQ
The previous SEQ can be made problem based
A 46 year old female patient comes to you with a history of
generalized weakness, palpitation, excessive sweating, and heat
intolerance for the last one year. In spite of a good appetite, she
has lost 10kg of weight during this period.
a) What is your provisional diagnosis? Justify (2marks)
b) What investigations will you advise to support your diagnosis?
(5marks)
c) Outline the steps in the management of this patient
(8marks)
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11. MEQ Matrix
 History
 Clinical/ Physical examination
 Diagnosis and assessing the condition
 Management including investigations
 Complications
 Prognosis
 Health education and prevention
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12. Design & Construction of MEQ
 Begins with a brief scenario of patient’s presenting problem
Followed by short answer questions those
 Seek identification/explanation or justification (C1/C2)based on
knowledge of underlying mechanism involved in the problem
 Seek to assess the analytic , problem solving (C3/C4) and decision
making (C5) skills through successively interconnected questions
 Have allocated marks and time for each item (Blueprinting)
 Are Scored / Marked by using predetermined model
answers(Blueprinting)
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15. 15Clinical Scenario provides the basis of
MEQ and has the following :
- the presenting problem of a patient; followed by
- the history
- the physical findings
- results of diagnostic work-up
- initial treatment
- subsequent findings, etc.

16. 16MEQ
Clinical Scenario
You are a young medical officer in paediatrics, you are called to
assess a one-hour-old baby with increasing respiratory rate and
sub costal recession.
Baby delivered prematurely at 35 weeks through LSCS.
Mother had pre-eclampsia and gestational diabetes.
Q1. List TWO probable diagnosis for this clinical presentation
Q2. List THREE essential investigations you would carry out at this point
Q3. Explain the basic pathophysiology for each of the TWO provisional
diagnoses

17. Construction of MEQ
The language used in a question should
be simple, clear, straight forward and
correct as per the terminology in use.
Scoring system : split the total marks
allotted into each part of the question
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18. Writing Test Questions
 A QUESTION SHOULD BE CLEAR, SPECIFIC AND WITH EXACT LIMIT
 AVOID - WHAT DO YOU THINK ?
- WHAT IS YOUR OPINION ?
- DISCUSS
 INSTEAD USE - LIST / ENUMERATE / DEFINE (C1)
- COMPARE / CONTRAST/ EXPLAIN (C2)
- GIVE REASONS / JUSTIFY /IDENTIFY (C2,C3)
- INTERPRET, ANALYSE, (C 4)
- PLAN OF MANAGEMENT (C5)
 MATCH THE QUESTION TO SPECIFIC LEARNING OUTCOME. IT SHOULD
COMMUNICATE CLEARLY TO THE STUDENT WHAT IS EXPECTED
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19. Writing Test Questions
 Number the test questions continuously
 Keep the test questions as standardised as
possible for each test group
 Make the layout presentable/simple.
 Do not put too many questions in a single
group
In MEQ usually 8-10 questions are needed in 5-
6 stages.
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20. The MEQ includes questions that deal with
problems typically encountered in general
practice that might present to a GP
The content may vary from common clinical
problems or an environmental issue, which
impacts on the community
It is designed to test decision-making skills. It
to assess the candidate's ability to identify the
issues involved and logically resolve them
their cognitive skills
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