title: Evaluation of essay questions used to assess medical students' application and integration of basic and clinical science knowledge.
abstract: BACKGROUND
  Educators need approaches to assess medical students' abilities to apply and integrate concepts essential to medical practice.
  
  
  METHODS
  We used a multimethod approach to examine the quality of essay questions intended to elicit medical students' ability to apply and integrate their understanding of medical concepts.
  
  
  RESULTS
  Three educators assigned essay questions (n = 120) to one of four levels of cognition. Kappa was computed before and after discussion. Faculty (n = 46) critiqued essay quality using a checklist (97% response), and students completed a questionnaire about the learning environment (91% response).
  
  
  CONCLUSIONS
  We identified effective approaches to evaluate the quality of essay questions and to train faculty to write essay questions of sufficient complexity. This systematic review of essay questions also encouraged review of the curriculum to determine if core concepts were being taught. It is feasible to have faculty write and critique essay questions targeted at higher levels of cognition.
authors.affiliation: Education Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio 44195, USA. biererb@ccf.org
authors.forename: S Beth
authors.initials: SB
authors.lastname: Bierer
authors.forename: Christine A
authors.initials: CA
authors.lastname: Taylor
authors.forename: Elaine F
authors.initials: EF
authors.lastname: Dannefer
mesh_terms: D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015510:Clinical Medicine / Q000193:education*; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D012586:Science / Q000193:education*; D011795:Surveys and Questionnaires; D014956:Writing