Introduction
Assessment in the educational field commonly uses Multiple Choice Questions (MCQs), because this question type offers high reliability and easy machine-marking. However, it also allows for cueing (i.e., answering questions based on cues in the question or answer options rather than on content knowledge) and stimulates a recognition-based study approach [Although other question formats have been proposed to circumvent the limitations of MCQs, such as uncued questions and extended matching questions [Although the use of VSAQs in medical assessments is increasing, evidence regarding validity and reliability of this question type in the medical setting is mainly based on studies from a single research group, consisting of teachers experienced in developing and marking VSAQs [However, it remains unclear whether the application of VSAQs by teachers with less experience in writing and marking VSAQs, in a different population, country, and medical educational setting yields the same results. Before VSAQs can be implemented in a wider context, more evidence is needed. Therefore, we aimed to externally validate the positive results of VSAQs regarding reliability, discrimination, and acceptability in a cohort of Dutch medical undergraduate students with non-expert teachers. Additionally, we wanted to explore the impact of VSAQs on cueing effects and student experiences of VSAQ-assessment. In order to achieve these aims, we partially replicated the study design of Sam 