Advantage and limitations of MCQ Structure of MCQ Rules and Guidelines of MCQ item construction Common flaws in MCQ item construction Advance MCQ item writing principles Out line State the advantages and disadvantages of using multiple choice items for testing ID: 1032230
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1. Multiple Choice Items
2. What is MCQ?Advantage and limitations of MCQStructure of MCQRules and Guidelines of MCQ item constructionCommon flaws in MCQ item constructionAdvance MCQ item writing principlesOut line
3. State the advantages and disadvantages of using multiple choice items for testingDescribe the components of well structured multiple choice itemDevelop quality multiple choice itemsLearning out come
4. Multiple choice (objective response) is a form of an objective assessment in which respondents are asked to select only correct answers from the choices offered as a list.Definition
5. Quick and easy to score, manually or electronicallyAppropriately constructed MCQs can measure higher order thinkingEasier to control the difficultly levelCan cover lots of content areas on a single examAdvantages of using MCQ
6. Time consuming to construct good MCQ itemsNeed skill to construct good MCQOften test knowledgeProvide students the opportunity to guessLimitations of using MCQs
7. Structure of a multiple choice question consists of:The stemThe lead-inOptionsStructure of MCQ
8. The stem presents the stimulus or information needed to answer the questionGood stems are written in the form of vignette (illustration), including Age Gender Presenting complaint Pertinent history Physical examination findings Results of diagnostic and laboratory studiesThe Stem
9. Example of a stem:A 24 year old woman came to a hospital with a complaint of sudden onset of lower crampy abdominal pain associated with spotting and claimed amenorrheic for the last 2 months.
10. The lead-in presents the specific question that defines the task and establishes the relationship between the stem and options E.g. Which of the following is the most likely diagnosis?The Lead-in
11. The option set ,the choices provided after the stem; It includes:The key- the correct answer in the list of optionsDistracters -the incorrect answers in the list of options The Option Set
12. Make sure that MCQs relate directly to learning outcomes; and are at different levels of learning (recall, comprehension, application and problem solving, etc.) Use vignettes to structure the stemBe aware of the difficulty level of each questionBasic Rules of item construction
13. Make sure you have a sufficient number of easy and more challenging questions Try to make the first few multiple choice questions relatively easy to help calm student …basic rules
14. StemProvide a complete statementInclude only relevant informationPut central idea in the stemKeep stems as short as possibleAsk for the correct, not “wrong” answerGuidelines for Developing MCQ Items
15. OptionsHave only one correct answer Consider the number of distractersAvoid long optionsKeep options similar lengthKeep options grammatically consistent with the stemWrite the correct response with no irrelevant clues guidelines...
16. OptionsWrite incorrect options to be probable but clearly incorrectLink options to each other (e.g., all diagnoses, treatments)Write distracters to be similar to the correct answer in terms of grammar, length, and complexityAvoid “none of the above” or “all of the above”guidelines…
17. OptionsPlace options in logical order (e.g. numerical, chronological)Avoid items like: A only, A+BWrite options to be not overlappingVary position of keyed responsesguidelines...
18. OptionsAvoid absolute terms such as “always”, “never”, “all”, or “none”Avoid imprecise terms such as “seldom”, “rarely”, “occasionally”, “sometimes”, “few”, or “many”Avoid cues such as “may”, “could” or “can”
19. Common Flaws in crafting MCQs
20. An asymptomatic 57-year-old man comes to the physician for a routine health maintenance examination. His blood pressure is 180/112 mm Hg, and pulse is 82/min. Abdominal examination shows a bruit in the right upper quadrant and no masses. The most likely cause of this patient’s bruit is an:A) accumulation of lipids in the arterial wallB) hypertrophy of the arterial wall mediaC) giant cell infiltration in the arterial wallD) round cell infiltration in the arterial wallGrammatical Cues
21. Crime isEqually distributed among the social classesOverrepresented among the poorOverrepresented among the middle class and richPrimarily an indication of psychosexual maladjustmentReaching a plateau of tolerability for the nationLogical Cues
22. Which of the following statements is the most accurate about croup in children?Can be treated adequately with oral dexamethasoneCould be a complication of hypercalcaemiaIs never seen in patients under 3 monthsIs rarely fatal Possibly relates to immaturity of cartilaginous developmentAbsolute or vague terms
23. A 67-year-old woman is brought to the emergency department because of severe chest pain four hours after undergoing outpatient endoscopy and dilatation of an oesophageal stricture caused by reflux.Which of the following is the most likely cause of these symptoms?A) Oesophageal perforationB) Mallory-Weiss syndromeC) Myocardial infarctionD) Perforated gastric ulcerClang Association (Repetition of words in the options)
24. Which of the following best describes the commonest organism causing bacterial pneumonia in childhood?Gram positive coccus, occurring in chainsGram positive coccus, occurring in pairsGram negative coccus, occurring in pairsGram negative coccus, occurring in chainsGram positive bacillus, occurring in pairsConvergence Strategy
25. Inconsistent proportions or unitsWhat is the incidence of hospital admission due you to post abortion complication?1%3%5%15%one quarter
26. Divide into groups Construct five multiple choice questions; three correctly constructed and two containing common errorsPresent to the large group for discussionTime: 20 minutesGroup Exercise
27. Advance MCQ Item writing Principles
28. A tool for new item writersCan develop new items, using shells constructed from items with good track recordsItem shell
29. A (patient description) has (history findings) and is taking (medications). Which of the following medications is the most likely cause of his (one history, PE or lab finding)?Sample templet for an Item Shell
30. A (patient description) has (abnormal findings). Which [additional] finding would suggest/suggests a diagnosis of (disease 1) rather than (disease 2)?Sample…
31. A (patient description) has (symptoms and signs). These observations suggest that the disease is a result of the (absence or presence) of which of the following (enzymes, mechanisms)?…Sample
32. A (patient description) has (symptoms, signs, or specific disease) and is being treated with (drug or drug class). The drug acts by inhibiting which of the following (functions, processes)?Sample…
33. Design new items from existing items by altering:Setting (Hospital or Clinic)Level of Clinical Decision Making Process (Data Collection or Planning)Type of Case (eg. Antepartum or Postpartum)Item Modeling
34. Used to assessCritical thinkingProblem-solvingDecision- makingContext-dependent item sets
35. A 24 years old female has been receiving care in your health center since learning that she was HIV positive three years ago. Never started on ARTFrequent episodes of generalized body weaknessRecurrent vaginal candidiasis which failed to respond to clotrimazole suppositories on two occasionsMaintains full time employmentExample: Case Study
36. Question 1:Which of the following WHO stage is this patient in based on the available clinical informationStage IStage IIStage IIIStage IVKey:C
37. Question 2:Which of the following laboratory tests would be MOST important prior to initiating ART? Total lymphocyte countCD4 cell countViral loadKOH test and/or wet smear for diagnosis of candidiasisKey:B
38. Divide in to groupsDevelop three multiple choice items each that measuring knowledge , application and analysis /evaluation (clinical decision making) skillsWrite down items on to computer and present to large group for discussionTime: 20 minSmall Group Exercise
39. Thank you!