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The MCQ Controversy-A Review.

It is now two years since my argument in favour of multiple choice questions and the late Sir George Pickering’s views against the technique were presented in Medical Teacher (Anderson 1979; Pickering 1979). Since then there has been a lively and stimulating continuing correspondence in the journal’s columns on this topic. In particular, the letter from Mr Barker and Dr Maatsch (see Appendix 1) raised some important issues which deserve to be answered but at the same time included some statements that I find difficult to accept. Mr Barker and Dr Maatsch also interpreted some of my own views in a way which I do not think is justified and drew some conclusions from my paper which I feel are unwarranted. I delayed replying to this letter at the time partly because of the pressure of other commitments and partly because I wished to wait to see what further correspondence appeared. In this regard I was not disappointed, since the letter from Dr Marshall (see Appendix 2) also makes some fundamental points worthy of further discussion. Like Dr Marshall I am delighted to note the obvious involvement and interest that has been generated in this topic at an international level. However, what began as a simple pair of arguments ‘for’ and ‘against’ MCQs has developed, as I felt it would, into a useful exchange of views and opinions on the more detailed aspects of MCQ technique and usage, the bulk of the correspondence seeming largely to accept the MCQ principle. There is, nevertheless, clearly (and inevitably) a lack of agreement on the finer points. Perhaps this is a good thing; too much conformity is not necessarily an advantage and in a contentious area like this it would be unrealistic to expect complete agreement on all aspects of such a wide-ranging topic. Nevertheless, perhaps the time has come, if not to sum up and to close the discussion, then at least to review the present situation and to emphasize the salient points which the correspondents in Medical Teacher have made.