The University of North Carolina at Chapel Hill medical school uses an objective structured clinical examination as the final exam in physical diagnosis. Since 1987, students and evaluators have shown overwhelming acceptance and support of the test, partly because it is structured for teaching as well as assessment. (Author/MSE)

An approach to testing medical students' clinical decision-making skills identifies key features (critical steps in resolution of a clinical problem) and presents a clinical case scenario followed by questions focusing on those key features. Key-feature problems provide flexibility on issues of question format, multiple responses to questions, and…

Interactive computerized tests accepting unrestricted natural-language input were used to assess knowledge of clinical biophysics at the State University of New York at Buffalo. Comparison of responses to open-ended sequential questions and multiple-choice questions on the same material found the two formats test different aspects of competence.…

The process proposed for the development and use of computer-based testing, including simulation and multiple-choice questions, as part of the National Board of Medical Examiners' certification sequence is outlined. Summary reports of first-phase pilot testing in six medical schools are appended. (MSE)