Multiple-choice examinations have been much maligned by both faculty and students. Faculty complain that MCQ only test the recognition of information at the knowledge level and students complain that MCQ are picky and ambiguous. Multiple-choice examinations do share some of the limitations of other objective tests. They deny the demonstration of learning beyond that which is included in the alternatives provided in the question and they encourage guess­ing. Although, scoring is a rapid proced­ure, constructing good objective questions is diffi­cult and very time consuming partic­ularly if the questions are going to measure levels of thinking above simple factual know­ledge.

Multiple-choice examinations also share some of the advantages objective tests have over essay style tests. Since object­ive questions require less student time to answer than essay questions it is possible to test the objectives of the course more comprehensively and to test the student through a wider range of difficulty levels. Object­ive tests can be scored much more quickly and accurately (often by machine) than essay tests which is often an important consid­eration for large classes.

The multiple-choice format is most frequently used to test knowledge and comprehension but instructors with expertise in writing MCQ can devise questions to evaluate higher order learning that includes, Application, Analysis, Synthesis and Evaluation. MCQs can also be used to assess the ability of students to integrate informa­tion from several sources. However, since MCQ which test higher-order learning require signifi­cant intellectual effort both in reading and answering, students often become anxious when confronted with questions of this type.

Some of the ‘faults' of multiple-choice examinations are not intrinsic to the MCQ themselves but rather result from a lack of skill in constructing clear, unambiguous, challenging questions which measure the level of cogni­tive perform­ance and higher-order thinking which best match the objectives of the course.