I’ll echo Jim’s comments about not grading applications.  I do not grade applications, because there is almost always more than one reasonable answer.  There might be a best answer, but if it is a really complex issue or the best answer is conditional or controversial, students may get frustrated with grading.  You don’t want them to think the questions were designed to trick them.  I would rather have rich discussion about the strengths and weaknesses of different answer choices and try to facilitate the teams reaching a consensus about (for example) why A is usually the best answer, but under certain conditions B is the best answer.  That lets you explore real life situations in any discipline, and perhaps especially in medicine.  Students will be uncomfortable with such uncertainties, and probably won’t like it at first when you tell them that is real life (patients don’t come with an answer key, a doc has to figure it out and there might be more than one plausible answer to every question, e.g., differential diagnosis, treatment plan).  Most people I've talked to about this include other measures of individual learning, such as exams, to ensure that learning objectives are being met.  So go for “messy questions” as Jim calls them, because they generate the rich discussion you want your students to have. 

Best regards,

Wayne

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