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There are clearly several approaches you can take to actually answering MC questions. While there are a number of variants, the major distinction appears to be between: (1) reading the stem, deriving the answer in your mind, and then actively trying to find the answer within the available alternatives--we'll call this the answer-search method. (2) Another approach, which we'll call the elimination method, involves crossing off the clearly incorrect alternatives and then making judicious selections from among the remaining possibilities.

The answer-search method has an intuitive component as you are able to capitalize on your very impressive recognition memory. Did you know that you would be correct in excess of 95% of the time if I showed you 1,000 slides and then showed you these 1,000 intermixed with 1,000 new ones and asked you to indicate which ones you'd seen before? Yes, our recognition memories are very impressive and many students like MC questions because they allow them to use this very powerful cognitive tool.

There is a problem here though. Recognition memory has a non-verbal, intuitive character that makes it difficult to analyze and, for some, very difficult to depend upon. When researchers, teachers, or students make assertions about anxiety being a problem on MC exams they are often referring to this component of memory as tension can interfere with recognition. It seems that being relaxed and confident (perhaps not over-analyzing) helps recognition memory do its stuff.

Many students indicate that they use a combination of the answer-search and elimination methods during a quiz. They go through the questions first using the answer-search strategy. To capitalize on recognition memory, some indicate that they try to keep fairly relaxed and "distant" from the items--waiting for the correct answer to "jump out" at them. If a clearly correct answer doesn't emerge easily, they move on to the next question. After this first pass, they then go through the items again using elimination. They spend more time properly rejecting the incorrect alternatives and maximizing the chances of picking the correct answer. In cases where they can't reject all but one alternative, many students will make their best educated guess at this point. In some cases using a system like this can help a student bring written and MC performance into harmony.

A note of caution though. You should try to bring your approach to answering MC questions into concert with your natural ways of doing things. To impose a foreign approach onto your already well-established approaches to exam writing could cause problems. The only sure antidote here is "practice, practice, practice." Get your hands on old exams, buy the study guide (if it has MC questions in it), do everything you can to work with the material, and try out different strategies. If you do this then you can enter the exam with confidence and focus on the questions rather than your strategy.

Some courses too, don't focus as much on recognition in the MC questions--you have to be pretty careful here as the answer-search method might not work very well in such cases. Consulting with students who have taken the course from the same prof recently is a good way to find out if this is problem, especially if they can show you a copy of the exams used.
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