Incorporation of Bloom's Taxonomy into Multiple-Choice Examination Questions for a Pharmacotherapeutics Course

Objective. To incorporate Bloom's taxonomy into multiple-choice examination questions in a pharmacotherapeutics course and assess its effectiveness in detecting areas of improvement in learning. Design. Bloom's taxonomy was incorporated into examination questions through a multi-step process: Sample questions representing each learning domain within Bloom's taxonomy (knowledge, comprehension, application, analysis, synthesis, and evaluation) were introduced to students during lecture presentations and discussions. Quiz and examination containing questions categorized according to Bloom's taxonomy were administered to students. During review sessions following each quiz or examination, the categorization of each question was provided to students and feedback from students was gathered. Assessment. The effect of the 5 types of test questions on the correct response fraction and discrimination index was determined after combining synthesis and evaluation. Correct response fractions for knowledge, comprehension, and application questions were significantly higher than those for analysis and synthesis/evaluation questions (p<0.05). However, discrimination index for application and synthesis/evaluation questions were significantly higher than those for knowledge and comprehension questions (p<0.05). In interviews with students who had requested learning assistance, the majority realized the importance of critical-thinking skills in the learning process. Conclusion. Well-designed multiple-choice questions incorporating different learning domains of Bloom's taxonomy may be a potential method of assessing critical-thinking skills in large classes of students.