In repeated-measures analysis pooling all data , mean posttest knowledge scores were highest for the @ - and @-question formats ( @ -LSB- @ -RSB- and @ -LSB- @ -RSB- , respectively ) and lower for @ - , @ - , and @-question formats ( @ -LSB- @ -RSB- , @ -LSB- @ -RSB- , and @ -LSB- @ -RSB- , respectively ) ; P = @ for differences across all modules .