Context: The accuracy of summative assessment scoring and discriminating the level of knowledge in subject matter is critical in fairness to learners in health care professional programs and to ensure stakeholders of competent providers. An evidence-based approach to determine examination quality for the assessment of applied knowledge is imperative. Objective: To present a written assessment question format that is simple to construct, can be scored electronically, and will accurately assess the application of knowledge in examinations during the classroom curriculum and for high-stakes examinations. Background: Traditionally, free-response written assessments have been administered to assess the application of knowledge, for example, short answer or essay questions. Selected-response questions such as a carefully constructed multiple-choice questions or extended-matching questions (EMQ) are reliable and valid options to assess the depth of understanding in subject matter. Description: Extended matching is a selected-response question format used to assess the application of knowledge. It consists of items consistent with a common theme and a large list of homogenous options providing distractors and a correct answer. Clinical: Advantage Extended-matching questions have demonstrated good psychomotor measures and can assess the application of knowledge over a large number of themes in 1 examination. They are simple to create, minimize cueing, and are scored objectively. Conclusions: Both well-written multiple-choice questions and EMQs can be used to assess the application of knowledge level of cognition. The EMQ is easier to write with less chance of cueing or guessing the correct option and is optimal for evaluation and treatment scenario type questions.