As mentioned in my post above, asking open ended questions is the best way to get to the truth from the perspective of the individuals insight. Multiple choice formats do work BUT only if after the student provides their choose of an answer, and we then provide them with the best answer to verify whether their chosen answer is right or wrong. This is called feedback. Multiple choice questions without feedback would otherwise be worthless. In my world of medicine, we license physicians in the USA by a series of multiple choice exams called USMLE. This exam gives areas of performance on a percentile scale, and this is reported back to the physician as to how they are performing in particular range of areas. If you "pass" by a certain standard decided by our profession in the Great US of A, your are by law allowed to lay hands on patients (that would otherwise be considered assault) and then order herbs, toxins and potions that in other hands would kill or harm. If the physician passes but knows he may still be in a lower passing percentile then s/he would otherwise desire, they have the opportunity to advance in this area through focused Continuing Medical Education. So to clarify, "What got accomplished? Nothing." This is how we evaluate physicians after they have been trained and I have awarded them their MD degree. Are you saying I have accomplished nothing in sending these students out to practice on you the patient? I truly hope this is not the case. Once again, my theory is that multiple choice questions do work in advancing knowledge if they are linked to feedback. So I would say in this context, Multiple choice questions accomplish something, whether used in the art of music or medicine.