Multiple-choice-questions are common in medical examinations, but guessing biases assessment results. Confidence-based-testing (CBT) integrates indicated confidence levels. It has been suggested that correctness of and confidence in an answer together indicate knowledge levels thus determining the quality of a resulting decision. We used a CBT…

The confidence level (information-referenced testing; IRT) design is an attempt to improve upon the multiple choice format by allowing students to express a level of confidence in the answers they choose. In this study, the author evaluated student perceptions of the ease of use and accuracy of and general preference for traditional multiple…