Junaid Sarfraz Khan, Osama Mukhtar, Saima Tabasum, Naveed Shaheen, M. Farooq, M. Abdul Irfan, Ajmal Sattar, M. Nabeel, M. Imran, Sadia Rafique, Maryam Iqbal, M. Sheraz Afzal, M. Shahbaz Hameed, Maryam Habib, Uzma Jabeen, Malik Hussain Mubbashar


Background: A number of evaluation tools for assessing the cognitive and affective domains in
accordance with Bloom’s taxonomy are available for summative assessment. At the University of
Health Sciences, Lahore, Multiple Choice Questions (MCQs) and Structured Answer Questions
(SAQs) are used for the evaluation of the cognitive domain at all six hierarch levels of taxonomy
using the tables of specifications to ensure content validity. The rationale of having two evaluation
tools seemingly similar in their evaluative competency yet differing in feasibility of construction,
administration and marking is being challenged in this study. Methods: The MCQ and SAQ
awards of the ten percent sample population amounting to 985 students in fifteen Medical and
Dental Colleges across Punjab were entered into SPSS-15 and correlated according to the
cognitive and affective level of assessment in relation to the Bloom’s taxonomy and their grouping
in the Tables of Specifications, using parametric tests. 3494 anonymously administered
questionnaires were analyzed using ethnograph. Results: No statistically significant difference
was found in the mean marks obtained by the students when MCQs and SAQs were compared
according to their groupings in the Tables of Specifications at all levels of cognitive hierarchical
testing. End-of-year cognitive level testing targets set were not met and more questions were set at
the lower cognitive testing levels. Expenses incurred in setting MCQs and SAQs were comparable
but conduct and assessment costs for MCQs and SAQs were 6% and 94% of the total respectively.
In both MCQs and SAQs students performed better at higher cognitive testing levels whereas the
SAQs and MCQs were able to marginally test the lower levels of affective domain only. Student’s
feedback showed that attempting MCQs required critical thinking, experience and practice.
Conclusion: MCQs are more cost effective means at levels of cognitive domain assessment.
Keywords: Cognitive Domain, Affective Domain, Bloom’s Taxonomy, Tables of Specifications,

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