True or False: Are multiple choice exams relevant to 21st Century education?














Will it be on the exam?

In-class exams may well be one of the most stressful – and for some, traumatic – experiences in a student’s life. This truism came front and centre last week at a certificate program I was teaching, geared to seasoned interprofessional practitioners. The varying responses to our in-class, summative, multiple-choice exam tended to cluster around the less enthusiastic end of the spectrum.

Why are exams so aversive?

One obvious reason is that they can be high stakes, as in this (admittedly oversimplified) equation:

high grades = approval + scholarship $$$ + grad school admission

Another reason may have to do with lack of autonomy: we didn’t write the exam questions, and we generally can’t know – or in many cases – anticipate – them in advance. And people inherently strive towards personal autonomy.

But I think that radical pedagogical analyses get closest to the crux of the matter, in their critical interrogation of power dynamics in the classroom, the stance of the professor as “expert”, and framing of “curricular content” (for example, Laura Béres 2008 article).

Constructivism frames learning as socially constructed by learners, where learning is meaningful and relevant to real life. In-class exams are, by nature, removed from real life and focus on content domains that the instructor sees as key.

This can be an uneasy alliance in progressive classrooms, and one that I am still struggling to reconcile… Especially in a knowledge landscape where locating information should take precedence over memorizing information (see Julio Frenk’s influential report in the Lancet, “Health professionals for a new century: transforming education to strengthen health systems in an interdependent world”).

Closing thought:

Exams do stimulate affective arousal, which is associated with enhanced memory retention. I’m just not sure that those memories correlate well with the exam content!

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