Most students have had ample practice at multiple choice question exams. Nevertheless, some candidates have particular difficulty with this part of the examination, and in many cases, this is due to poor examination technique. The following help and advice is applicable to all negatively marked mcq examinations.
It is important that all examiners and candidates should have a clear understanding of mcq terminology. You may find helpful, the following advice usually issued to the exam question conveners.
"Recognised" means "an accepted feature of the disease".
"Pathognomonic" means "a feature specific to the disease, and to no other".
"Characteristic" means "a feature without which the diagnosis is in question". This term must therefore be used with care.
"Typical" is synonymous with "characteristic".
"The majority", "most" or "usually" mean over 50%.
Percentages as a specific figure are unacceptable, and should be given as a range e.g. 30-40%.
Vague non specific terms e.g. "commonly", "frequently", "often" and "rarely", should be avoided .
Use of "can" or "may" typically demand a true response, and should therefore be avoided.
Absolute terms "always", "never" and "invariably" similarly demand a false response and should also be avoided.
Eponyms should be defined unless in common use [e.g. Crohn's disease].
Avoid double negatives.
Male : female incidence ratios are usually pointless items.
Intuition and Guessing Answers
As most of the exam is negatively marked, many candidates erroneously believe that guessing will not significantly influence their marks. Random guessing in a (+1,0,-1) negatively marked exam should produce a zero overall average score gain.
Some candidates will not guess answers, worried that they will have a net score loss. It is not uncommon for conscientious candidates to feel particularly anxious, and even pessimistic on the day of the exam.
In practice however, most candidates know at least something about the question being asked. It has been shown for the majority of candidates, guessing answers intuitively will improve marks. Represented graphically, the improvement approximates to a normal distribution about a mean. Most candidates increase their score. A minority of "bad guessers" will be worse off.
The trick is to know which questions to guess. You should practice your technique before the exam, using mock examination papers. Complete the exam as you would normally, and calculate your marks. Then go back, guessing at the questions you answered "Don't Know" to, and calculate your change in score. As you practice guessing, you will develop a feel for which questions you should attempt. In the unlikely event you turn out to be a consistent "bad guesser", it is probably best you don't!
The following tips may help your intuitive guessing strategy:
Use any clues in the question terminology. Give away words such as "may" and "always" sometimes slip through the question selection process.
Examiners are usually trainers, and want to teach you something. If you have never heard of the question topic, the stems [A-E] are more likely to be true.
If you have heard of the question topic but are not aware of an association raised in a question stem, it is probably false.
Remember, you will make errors and incorrect answers in every exam. Even if you answer only the questions you think you know the answers to, you are likely to get 5% wrong. If you answer only 200 out of the 300 question stems, you will almost certainly fail.
Some candidates prefer to jot their answers on the question paper, and then transcribe their answers after completing the all the questions, or in batches at the end of each page. It beggars belief how many times I have seen candidates frantically transcribing their answers, whilst arguing with the invigilator who is trying to collect the answer papers at the end of the exam!
It is not surprising that transcription errors are made. As errors are propagated, a whole series of answers may be incorrectly transposed. If you do not detect these or, even more disheartening, do not have time to correct them, you will almost certainly fail.
The simple answer is DO NOT TRANSCRIBE YOUR ANSWERS.
Fill in the boxes on the answer paper as you complete each question. If you are unsure about an answer, put a mark next to the question on the question paper to remind you to review the question later. Make sure the question and answer numbers correspond each time you enter an answer. Any transcription errors should then be detected early, before disaster ensues.
Leave 5-10 minutes at the end of the exam to go through the answer sheet to make sure every question has been answered. The answer papers are read by machine which pauses and asks the operator to advise it whether no response has been offered, or if there is a response that it is unable to read. This slows down the marking process. The co-operation of candidates in ensuring that they record a clear response to all questions is much appreciated and aids the examiners in being able to provide speedy results to candidates.