Strategy choices in responding to multiple choice item

The objective of this study was to use a think aloud approach to examine the strategies and reasoning used by medical students in responding to a set of multiple choice items.;Students were asked to think aloud while being presented with each multiple choice item. The notes recorded during each interview, the transcripts and the literature on problem solving, enabled the classification of examinee-item interaction activities or "moves". The moves were grouped into three categories. The first category contained five global item-related moves which dealt primarily with whether examinees generated an answer prior to reading the alternatives and the actions taken by the examinees with respect to the alternatives. Sixteen moves comprised the second category which dealt with disposition of alternatives. The third category included four activities related to features of successful problem solving.;The list of 25 moves served as a preliminary framework for coding the think aloud protocols of the student-item engagements. Using the list of moves, three broad strategies were detected according to whether or not hypotheses (diagnoses) and answers matching in form the item alternatives were generated prior to reading the list of item alternatives.;The first broad response strategy pertained to a set of items for which students generated few answers matching in form the response alternatives prior to reading the item alternatives. In addition, students did not generate diagnostic hypotheses because this set of items did not request diagnostic hypotheses as a preliminary step to identifying the correct answer. The strategy used most frequently by the students was to read the stem, search the alternatives for an answer, select an answer and eliminate the remaining alternatives by providing a rationale for the incorrect choices.;The second response strategy comes from an item set for which few answers matching in form the item alternatives were generated but diagnostic hypotheses were advanced. For this set of items, students upon reading the stems, activated hypotheses (diagnoses) The generation of diagnostic hypotheses represents an intermediate activity because the items request tasks other than diagnoses. The list of alternatives is searched for an answer and a rationale is provided for the the discarded incorrect choices.;The third response strategy consists of students reading the stem, generating an answer which matches in form the item alternatives, searching the alternatives for a match and discarding the incorrect options.;The strategies illustrate the variations in thought processes encountered. The claim that multiple choice items assess only recognition cannot be sustained in these data. (Abstract shortened by UMI.).