Multiple Choice Question (MCQs) tests have long been used as assessment tools. A significant problem of MCQs tests is the positive grades bias introduced by guessing. This chapter describes a novel assessment tool in which the questions given in the test constitute pairs, referred to as “paired” MCQs (p-MCQs). Every pair addresses the same topic, but this similarity is not evident for a student who does not possess adequate knowledge on the topic addressed in the questions of the pair. The answers to the questions are graded in pairs, providing a bonus, if both questions of the pair are correctly answered, or a penalty, if only one of the pair's questions is answered correctly. If both answers are wrongly answered no marking is collected by the examinee. Application examples are reviewed, indicating that the p-MCQs method removes the guessing factor bias, in a way that might not overtly induce the dissuading effects of direct negative marking of incorrect answers, commonly used in mixed-scoring schemes.
