The role of computer-aided assessment in health professional education: a comparison of student performance in computer-based and paper-and-pen multiple-choice tests.

There is a lack of empirical research in the use of computers in assessment. A study was conducted to compare student performance in computerized and paper-and-pen multiple-choice tests and assess the extent and effect of 'computer anxiety'. The LXR.TEST 5.1 software was used for the computerized test. A validated rating scale was used to assess computer anxiety. Most students had little computer experience other than in word processing. Only about a third of the students had moderate to mild computer anxiety. Neither computer experience nor anxiety correlated significantly with performance in the computer test. Whereas students performed significantly better in the paper test than in the computer test, there was no statistical difference in ranking in the two assessments formats. This suggests that computer-based assessment could be used with confidence for the purposes of ranking students, but care should be taken in using it for grading.