Background: Assessment drives learning. Reliable and valid question papers of higher cognitive function are difficult to produce, particularly for assessment of clinical problem solving. The present study was undertaken to analyze the essay questions and item writing flaws in the summative anatomy question papers. Methodology: 4 years Summative assessment question papers were collected and analyzed, (16 question paper and 32 essay questions) for cognitive level and item writing flaws by two assessors separately. Essay questions were analyzed according to modified blooms taxonomy of cognitive levels and by using validated checklist items. Item writing flaws were analyzed using validated checklists. The results were analyzed using SPSS software. Results: Among 32 essay questions analyzed, all of them were at level 1 of cognitive level of Bloom Taxonomy. Majority of questions addressed the competency that could be assessed only with essay question, were aligned to learning outcomes, structure and pertaining to must know aspects of curriculum. Out of 32 essay questions 17.2% were of average, 51.7% were good and 31% were of excellent quality. In connection with item wise flaws, majority of questions were ambiguous 86.2%, 75.9% questions were repeated in multiple years, same areas of curriculum was addressed in 51.7% questions and there was unequal distribution of marks among different topics in 75.9% papers. Conclusion: Well-constructed, peer-reviewed question papers meet the educational requirements and are advocated for assessing medical students. To construct the higher level of cognitive domain the faculty has to be well trained.

Keywords: Essay Question; Cognitive Domain; Assessment; Item Writing Flaws.