Vb. Best Practices in Writing MCQs
C. Content and Relevance
1) Ensure the item assesses competency and not trivial knowledge.
1) Ensure the item assesses competency and not trivial knowledge.
Assessment in professional courses should focus on gauging a student's competency in key areas rather than testing their knowledge of trivia or obscure facts. Assessing competency is important because it ensures that students are equipped with the knowledge and skills necessary for real-world professional performance. Constructive alignment in test design, where assessments are aligned with desired learning outcomes, is a key principle in educational theory that helps ensure that assessment items directly relate to necessary competencies.
BASIC Information
Assessment in educational settings, especially in professional courses like medicine, is designed to gauge a student's competency in key areas. While trivia or obscure facts might be interesting, they often don't reflect a student's ability to function in their intended profession.
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Are multiple-choice questions a good tool for the assessment of clinical competence in Internal Medicine?Competency: Vital knowledge and skills required to perform a job or task effectively.
Trivial Knowledge: Information that might be "nice to know" but isn't crucial for job performance.
INTERMEDIATE Information
Relevance to Professional Performance: Focusing on competency ensures students are equipped with knowledge and skills that will be used in real-world settings.
Aligns with Learning Outcomes: Most courses have outlined objectives or outcomes. Questions should align with these, ensuring they are a relevant measure of a student's progress.
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Think twice before using multiple choiceFocus on Application: Questions should often lean towards applying knowledge rather than recalling obscure facts.
Feedback Alignment: Feedback from trivial questions may not offer students meaningful insights into areas of improvement.
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Assessing Higher-Order Outcomes using Multiple-Choice QuestionsQuestion: "A patient with suspected rheumatoid arthritis shows swelling in the PIP joints but not the DIP joints. What does this suggest?"
This question tests the student's understanding of rheumatoid arthritis's presentation, a necessary competency for diagnosis and treatment.
Versus:
Question: "In which year was rheumatoid arthritis first described in medical literature?"
While historically significant, this doesn't assess the student's ability to diagnose or treat the condition.
ADVANCED Information
A key principle in advanced educational theory is "constructive alignment," where learning activities and assessments are aligned with the desired learning outcomes. In the context of MCQs, this means ensuring each item directly relates to a necessary competency.
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When passing fails: Designing multiple choice assessments to control for false positivesUse Real-world Scenarios: Craft questions based on scenarios students might encounter in their profession.
Distractor Design: Even incorrect options (distractors) should reflect common misconceptions or areas where competency might be lacking, rather than trivial errors.
Continual Review and Revision: Regularly review MCQs to ensure they remain relevant as the field evolves and knowledge bases expand.
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Assessment of higher order cognitive skills in undergraduate education: modified essay or multiple choice questions? Research paperScenario: "A 40-year-old woman presents with morning stiffness in her hands lasting more than an hour, symmetric joint pain, and fatigue. Rheumatoid factor (RF) and anti-CCP antibodies are positive. What is the most likely diagnosis, and what is the primary mechanism involved?"
Options:
a) Osteoarthritis; Degeneration of cartilage
b) Rheumatoid arthritis; Autoimmune reaction
c) Lupus; Autoimmune reaction against various organs
d) Fibromyalgia; Unknown mechanism involving pain processing
Here, the correct answer is 'b'. This question tests both the diagnostic competency (identifying rheumatoid arthritis based on the description) and a deeper understanding of the disease mechanism. Even the distractors are designed around potential areas of confusion, ensuring that selecting the correct answer demonstrates a genuine competency in the subject matter.