Efficient validation of teaching and learning using multiple-choice exams. One purpose of this study was to quantify, by means of single-format, multiple-choice questions at the beginning and end of the course, the extent to which first-year medical students learn neuroscience material from an introductory course in their curriculum. Compared with their precourse test performance (mean = 41.8%), collectively, the students nearly doubled their grade by the end of the course (mean = 81.4%). Their scores in subcategories of the material improved in inverse proportion to what they knew initially. A second goal was to evaluate a two-dimensional, computer-generated matrix as a way to assess test question validity and value. The evaluation of individual test questions as assessed from the matrix often, but not always, was similar to the classical pedagogical analysis that uses difficulty and discrimination indexes. Strengths of the matrix are its ability to render data as a gestalt, as well as flexibility and intuitive ease of use.