Table 4 Sample coding of MEQs

A 46 year old woman presents to the emergency department with a three month history of early satiety and anorexia. Over the last two weeks she has been vomiting most days and has been unable to eat or drink much over the last few days. Describe what other information you would seek from the history that would help you establish a diagnosis and justify your answers.

3

Knowledge recall is required, but there is significant interpretation of data required. This makes this a Bloom level 2 at minimum. However, there is a need to evaluate other data, not provided explicitly in this problem in order to arrive a t a diagnosis (problem solving skills). This makes this question a Bloom level 3.

From the history you think that the patient has gastric outlet obstruction. Describe the physical findings you would look for on examination and explain why they might occur.

2

Knowledge recall is required but the student requires understanding of a number of different processes to answer the question correctly. There is no problem solving required, thus making this a Bloom level 2 question.

<from a different problem> Assuming that a mammogram was to be performed as part of the work-up, what are the features suggesting malignancy that would be sought?

1

Knowledge recall of features of malignancy. Requires no understanding of the overall problem.