Extended Matching Items (EMI).

Abstract

Extended matching items (EMI) are an excellent method
to assess knowledge component of medical students.
EMI are gaining popularity in undergraduate and
postgraduate medical examination. It is believed that
EMI is a format in which clinical reasoning is easy to
test, particularly because a clinical scenario can be
constructed with related questions1. Moreover, there are
many options (about ten or so); therefore, the candidate
is only likely to guess correctly in 10% of cases. Since
an examiner in medical school aims to assess
application of knowledge rather than simple recall, he
likes the format of question that takes the form of a
small problem (short case or vignette). A surgical case
is described in three to six sentences starting with
patient’s age, gender, chief complaint and site of
problem followed by personal history, family history (if
relevant), physical signs , results of lab tests and
radiology etc. and then he asks the student to arrive at a
diagnosis. This is chosen from a long list (ten or so)
rather than five choices. The spirit of testing in this way
is that having read and understood the vignette and the
information given in it, the student should be in a
position to produce the answer i.e. the diagnosis, and
choose this from the list.
Hence EMI can be conceptualized as an extension of
the more familiar MCQ format2. Most rules used in writing a good Single Best Answer (SBA) question also apply in EMI. A typical EMI has four components:
A theme,
An option list,
A lead in statement and
Two or more item stems