Development and validation of immediate self-feedback very short answer questions for medical students: practical implementation of generalizability theory to estimate reliability in formative examination designs

Very Short Answer Questions (VSAQs) reduce cueing and simulate better real-clinical practice compared with multiple-choice questions (MCQs). While integrating them into formative exams has potential, addressing marking time and ideal occasions and items is crucial. This study gathers validity evidence of novel immediate self-feedback VSAQ (ISF-VSAQ) format and determines the optimal number of items and occasions for reliable assessment.