ROBERT HWANG; MAX PALEY; DAVID BULL; OSAMA OMRANI; DIEGO VERGARA-JALANDONI; GERALD EGBURY
Abstract
Introduction: This systematic review and meta-analysis investigated the impact of utilising peer-generated multiplechoice question (MCQ) banks on the summative performance of undergraduate ...
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Introduction: This systematic review and meta-analysis investigated the impact of utilising peer-generated multiplechoice question (MCQ) banks on the summative performance of undergraduate students studying medicine and allied subjects. Answering and writing peer-made MCQ questions are hypothesised to enhance learning through achievement of thedomains of Bloom’s taxonomy and thus summative examination performance.Methods: A random-effects meta-analysis of correlation coefficients was conducted on six studies (n = 1,571) published between 2011 and 2021, drawn from MEDLINE, Scopus, Web of Science, PubMed, CENTRAL, and ERIC. The studies included undergraduate medical students from four countries. The risk of bias was assessed using the ROBINS-I tool.Results: A weak positive correlation was found between answering peer-made MCQs and summative performance (Spearman’s ρ = 0.22, 95% CI: 0.15 to 0.29, p < 0.0001), with a prediction interval of 0.00 to 0.42, indicating that in future studies, the effect of answering peer-made questions is likely beneficial or, at worst, neutral. A similar weak positive correlation was observed for writing peer-made MCQs (Spearman’s ρ = 0.21, 95% CI: 0.09 to 0.32, p < 0.0004), though the prediction interval (-0.27 to 0.61) cannot exclude negative correlation between writing questions and summative performance in future studies. The findings suggest that answering and creating peer-generated MCQs positively influence exam performance. The modest correlations likelyreflect confounding factors, such as prior academic performance and socio-economic background. This complicates isolating the impact of MCQ banks and may understate their true impact.Conclusion: This study advocates for the integration of peergenerated MCQ banks into medical curricula, highlighting their potential as a cost-effective method to improve summativeperformance. Future research should focus on large-scale observational studies to better quantify these effects as well as controlling for confounding factors. The study underscores the value of peer engagement in learning and the utility of peer-made MCQ banks as educational tools.