Modified essay questions: are they worth the effort?

The method chosen for important examinations strongly influences the nature of student learning. The Newcastle Medical School in Australia developed a 5-year problem-based curriculum and adopted the Modified Essay Question (MEQ) as the main written instrument for assessing students' problem-solving skills. Even with the best of intentions the MEQ has been abused by its over-use, as shown in this review of annual assessment for years 1, 3 and 5 of the course. Analysis of staff and students' dissatisfaction with this instrument showed some difficulties attributable to the nature of MEQ items. However, a number of problems also emerged as a result of subtle changes in the teaching staff's approach to learning and assessment. This paper concludes by acknowledging the strengths and limitations of the MEQ. It recommends ways in which the MEQ can be effective, as part of a balanced programme involving other suitable instruments.