Summative exam
AEES
The summative exams of RM and DA were rewritten to replace part of the MCQs with VSAQs (45 in RM and 16 in DA). For RM, this was done through rewriting existing MCQs, whereas for DA, a 2-hour workshop was organized for teachers on how to write VSAQs. Question writers in both courses received written instructions about how to write VSAQs based on information provided by the author of the initial paper on VSAQs, as can currently be found in the publication by Bala VSAQ review time per question for each teacher was recorded in DA to determine acceptability. The total reviewing time per question was recorded by the reviewer using the timer function on a smartphone. Reviewing time started when the reviewer first looked at the question and ended when the question was fully resolved. This included both reviewing the answers and discussion with other teachers when necessary. Because the marking of only a few VSAQs of the exam was recorded during the initial data collection, which impeded a correct and unselected overview of the reviewing time, one year later the reviewing time of all VSAQs in that year’s summative exam was collected again. The AEES questionnaire was supplemented with two questions regarding students’ insights: 1) 