A comparison of free-response and multiple-choice questions on the American Board of Pathology primary certification examinations

< 0.01. The short-answer questions, even when liberally graded, were much more difficult compared with the corresponding multiple-choice questions, even though the questions targeted for this evaluation were simple recall type items. The short-answer item responses raised questions about the clarity of the stem for one item, whereas the response to another item clearly disclosed a lack of understanding concerning the construct tested. The candidate survey regarding these question types disclosed an overwhelming candidate preference for multiple-choice questions.