Benning & Broadhurst (Psychiatric Bulletin, December 2007, 31, 441–442) raise an important issue with regard to the change in the MRCPsych exam format. In addition to the loss of long case, the new exam discards essays and critical appraisal in theory assessment. The loss of essay, in my opinion, deserves significant mourning.
Essays have traditionally been the only mode of testing logical arguing skills. This is an essential skill for any clinician in psychiatry given the intangible nature of certain domains of our clinical work. In the absence of a well-constructed arguing ability, team working and teaching cannot flourish.
Essays tested contemporary contents, unlike multiple choice questions which were obtained from a bank of questions. The creativity and reasoning abilities of a candidate are largely untested in the new format exam. This means we might get many qualified specialists in the future who read the specified syllabus and managed their time well at Clinical Assessment of Skills and Competencies (CASCs, formerly OSCE exams), though they never had a chance to prove that they are up-to-date with the developments in psychiatry or that they could think critically about a controversial issue in thefield. This is a great loss as the aforementioned are important and distinguishing skills for any psychiatrist.
I am a candidate who sat the last of old pattern MRCPsych part 2 exams and, like most of my peers, I spent a substantial amount of time researching the British Journal of Psychiatry, Advances in Psychiatric Treatment and Psychiatric Bulletin, as well as other journals, when preparing for my exams. Journal reading habit was cultivated strongly by essay papers in MRCPsych. This is not the case with multiple choice questions. Factual recall is tested equivalently by both multiple choice questions and essays (Reference Palmer and DevittPalmer & Devitt, 2007), but higher order cognitive skills including problem-solving cannot be easily tested by a set of questions (Reference Schuwirth, van der Vleuten and DonkersSchuwirth et al, 1996). It is, moreover, everyone's secret that the College uses a bank of questions with a high repetition rate for subsequent exams.
One argument against essay writing is standard of assessment, which could vary widely when an essay is evaluated. Standardisation of assessment could be attempted by structured essay evaluation tools. Removing essay writing completely and replacing it with multiple choice questions is a costly trade-off between assessment standards and abilities tested.
Multiple choice questions may be an easy option if one considers online delivery of exam modules in the future, but whether we need to give up on essay papers is a matter of serious debate. Fast food may be easy and appealing, but cannot solve all nutritional requirements!!
Declaration of interest
L.P. was awarded Laughlin prize for outstanding performance in old format MRCPsych exam, Autumn 2007. He is also involved in writing a multiple choice questions' book for the new format MRCPsych.
Declaration of interest
L.P. was awarded Laughlin prize for outstanding performance in old format MRCPsych exam, Autumn 2007. He is also involved in writing a multiple choice questions' book for the new format MRCPsych.
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