An Analysis of Medical Undergraduates' Performance on Problem-based Objective Written Questions Compared to Traditional Objective Written Questions on Circulatory System and Lymphoid Organs in Histology

Open Access

Abstract

Background: Histology is a fundamental component of undergraduate medical education, with assessment methods significantly influencing student learning and skill development. Problem-based objective written questions (PBQ) aim to assess higher-order cognitive skills, while traditional objective written questions (TQ) primarily evaluate recall and understanding. Objective: To compare medical undergraduates' performance in problem-based objective written questions and traditional objective written questions in histology, focusing on the circulatory system and lymphoid organs. Methods & Materials: This cross-sectional analytical study was conducted in the Department of Anatomy, Bangladesh Medical University (BMU), Dhaka, from September 2024 to August 2025. A total of 220 medical undergraduate students were included, with 110 students in the problem-based question (PBQ) group and 110 students in the traditional question (TQ) group. A structured test comprising 100 objective written questions was administered under standardized conditions. Only responses related to the circulatory system and lymphoid organs were analyzed. Data were analyzed using SPSS version 27.0, and statistical significance was set at p ≤ 0.05. Results: The mean score of the PBQ group was 31.59 ± 19.29, while the TQ group achieved a higher mean score of 38.48 ± 18.68. The difference between the two groups was statistically significant (p = 0.00). The 95% confidence interval (-7.29 to -7.06) confirmed significantly poorer performance in the PBQ group compared to the TQ group. Conclusion: Medical undergraduate students performed significantly poorer in PBQ than in TQ in Histology, particularly on the circulatory system and lymphoid organs. These findings suggest that students may require greater exposure and training in problem-based assessment formats to improve their application-level cognitive skills.