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One other point occurred to me.

We have tried to make the multiple-choice questions more organically built into the weekly flow, via the self test assessments. 

In future versions of the course, we anticipate making this even more organic, by embedding the multiple-choice questions within the lectures themselves (like the HIPAA training is), so students have to respond to them while they're listening to the lecture. In this way the multiple choice becomes more "mandatory", for lack of a better word, and helps students prepare better.

Thanks, Michael