Some misconceptions about written assessment may still exist, despite being disproved repeatedly by many scientific studies. Probably the most important misconception is the belief that the format of the question determines what the question actually tests. Multiple choice questions, for example, are often believed to be unsuitable for testing the ability to solve medical problems. The reasoning behind this assumption is that all a student has to do in a multiple choice question is recognise the correct answer, whereas in an open ended question he or she has to generate the answer spontaneously. Research has repeatedly shown, however, that the question's format is of limited importance and that it is the content of the question that determines almost totally what the question tests.

This does not imply that question formats are always interchangeable—some knowledge cannot be tested with multiple choice questions, and some knowledge is best not tested …