PEDIATRICS Vol. 93 No. 2 February 1994, pp. 264
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WHO ARE WE KIDDING?

If you answer questions on a multiple-choice test in a certain way. . . you will be credited with understanding. No one ever asks the further question "But do you really understand?" because that would violate an unwritten agreement: A certain kind of performance shall be accepted as adequate for this particular instructional context. The gap between what passes for understanding and genuine understanding remains great...

This state of affairs has seldom been acknowledged publicly, but even successful students sense their apparent knowledge is fragile at best. Perhaps this uneasiness contributes to the feeling that they—or even the entire educational system—are in some sense fraudulent.