|Modified Essay Question (MEQ)|
A measurement instrument which allows for assessment of clinical reasoning skills, understanding and knowledge of clinical and basic science and application of basic science to clinical problems. MEQ's constitute a series of questions which must be answered in the sequence asked, with no review and no possibility of correcting previous answers. Questions must be answered within the allocated time which may vary from 40 to 90 minutes. In general, a brief patient clinical scenario (presentation) is followed by a few questions exploring diagnostic hypotheses and mechanisms underlying the clinical presentation. Subsequent questions may focus on applied basic science, interpretation of diagnostic information, management issues, disease complications, ethical issues or prognosis, for example. The initial scenario is either repeated or reformulated as the reporting process progresses, and as further information is provided, the assessed area narrows. Thus the medical problem is progressively defined with questions being directed to increasingly specific areas. A well-written MEQ assesses the approach of students to a problem, their reasoning skills and understanding of concepts, rather than recall of factual knowledge.