The Assessment Alliance is a partnership to improve undergraduate assessment practice. This partnership consists of all undergraduate members of the Medical Schools Council. Its aim is to help ensure the confidence of the public, employers, and the regulator in the quality of medical school graduates by:
- Developing the highest quality assessments for undergraduate students, in turn enhancing their learning experiences
- Sharing experience and adding value through collaboration rather than competition
- Exploring the equivalency of the standards applied by medical schools
One of the main achievements of the Assessment Alliance is the development and running of a communal bank of examination questions that are accessible to all partner medical schools. These questions are developed collaboratively by assessment experts from the medical schools, then bespoke software is used to assist in a rigorous quality-assurance process. Medical schools can draw from the bank when arranging their formative and summative assessments.
Single best answer questions – Example 1
Please note: These are provided here as examples only and are not to be used or reproduced for any purpose:
A 47-year-old man has a two-day history of worsening epigastric pain, with nausea and vomiting. He drinks 70 units of alcohol per week. His temperature is 38.7ºC, pulse 120 bpm, blood pressure 102/65 mmHg and oxygen saturation 90% breathing air. He has upper abdominal tenderness with guarding.
Investigations
Urea 10.0 mmol/L (3.0-7.0)
Creatinine 131 umol/L (60-120)
Haemoglobin 133 g/L (130-180)
White cell count 21.8 x 109/L (4.0-11.0)
Platelet count 520 x 109/L (150-400)
Which additional blood test is most likely to confirm the diagnosis?
A. Amylase
B. Blood cultures
C. Calcium
D. Lactate
E. Liver function tests
Answer key A
Single best answer questions – Example 2
Please note: These are provided here as examples only and are not to be used or reproduced for any purpose.
A three-year-old boy has 24 hours of right knee pain and is unwilling to weight-bear. He had a chest infection two weeks ago, but is otherwise healthy with no other history of note.
His temperature is 38°C, pulse rate 118 bpm, respiratory rate 24 breaths per minute and oxygen saturation 99% in air. He appears unwell and lethargic. His right knee is red and swollen, warm to touch and tender on palpation with reduced painful range of movement. The patellar tap test shows a bouncing patella.
Which is the most appropriate investigation to establish a diagnosis?
A. Aspiration of knee joint
B. Blood cultures
C. MR scan of knee
D. Plain X-ray of knee
E. Ultrasound scan of knee joint
Answer key A
Single best answer questions – Example 3
Please note: These are provided here as examples only and are not to be used or reproduced for any purpose.
A 70-year-old man has a 24-hour history of central chest pain which is worse on inspiration. He had an ST elevation myocardial infarction one week ago.
His temperature is 38.9ºC, pulse 100 bpm, regular, blood pressure 100/60 mmHg, respiratory rate 16 breaths per minute and oxygen saturation 97% breathing air. A rub can be auscultated of the left side of the chest.
Which is the most likely diagnosis?
A. Acute coronary syndrome
B. Acute mitral regurgitation
C. Pulmonary embolus
D. Pericarditis
E. Ventricular rupture
Answer key D
Structure
The Assessment Alliance consists of a Reference Group which meets twice yearly and is attended by two senior assessment experts from each medical school. Elected from the Reference Group is the Board, which meets four times a year to lead the activities of the Assessment Alliance as a whole. Board members are as follows:
- Professor Mark Gurnell (Chair), University of Cambridge
- Professor David Kluth (Deputy Chair), University of Edinburgh
- Dr Andrew Blythe, Bristol University
- Professor Adrian Freeman, University of Exeter
- Dr Ellie Hothersall, University of Dundee
- Dr Elizabeth Metcalf, Cardiff University
- Dr Nimesh Patel, Queen Mary University of London
- Professor Amir Sam, Imperial College London
- Dr Phil Smith, Cardiff University
- Dr Rachel Westacott, University of Birmingham
Ex officio:
- Professor John Atherton, Medical Schools Council
- Dr Katie Petty-Saphon, Medical Schools Council
- Professor Malcolm Reed, Medical Schools Council
Twice a year the Assessment Alliance runs ‘expert item review’ events. These are attended by assessment experts from across the medical schools and are where questions are written and quality-assured by peers, overseen by members of the Final Clinical Review Group. After review and approval, they are added to the common bank of questions from which medical schools can draw.
To contact the Assessment Alliance team, call the Medical Schools Council or email directly: mscaa@medschools.ac.uk.
Publications
The following publications have emanated from or been facilitated by the work of the MSC Assessment Alliance:
- High-stakes, remote-access, open-book examinations - Professor Amir Sam et al
- National inter-rater agreement of standardised simulated-patient-based assessments - Professor Amir Sam et al
- Exploring differences in individual and group judgements in standard setting - Dr Peter Yeates et al
- Validity of very short answer versus single best answer questions for undergraduate assessment - Professor Amir Sam et al
- Variation in passing standards for graduation-level knowledge items at UK medical schools - Dr Celia Taylor et al
- Comparing single best-answer and very-short-answer questions for the assessment of applied medical knowledge in 20 UK medical schools: Cross-sectional study. - Professor Amir Sam et al
- The influence of candidates’ physical attributes on assessors’ ratings in clinical practice - Professor Amir Sam et al
- Variation in performance on common content items at UK medical schools - Dr David Hope et al
- Thinking differently – Students’ cognitive processes when answering two different formats of written question - Professor Amir Sam et al
- Making it fit: Examining the assessment of contextual knowledge and understanding in the positivist assessment modality of medical education - E.J. Hothersall, V. Rodrigues, M. Gordon, J.C. McLachlan, S. McAleer