WEEK 3: Selected Response Items (31 OF 34)

Vb. Best Practices in Writing MCQs F. Avoiding Bias and Stereotypes 1) Ensure that questions and images are free from cultural, gender, or other biases.
Bias in test items occurs when questions or images give an unfair advantage or disadvantage based on personal characteristics. Biased questions can lead to inaccurate evaluations and can make students from diverse backgrounds feel marginalized. In medical practice, biased test items can perpetuate stereotypes and hinder the development of culturally competent healthcare professionals.
BASIC Information
Understanding Bias in Test Items: Bias in test items occurs when a question or its accompanying images have content that gives an unfair advantage or disadvantage to a group of test-takers based on their personal characteristics such as culture, gender, race, or socio-economic status.	READ Guidelines and Suggestions for Avoiding Cultural Bias in Multiple-Choice Test Questions
Importance of Neutral Content: In the medical field, it's crucial to keep MCQs free from bias. Tests should measure a student's competence and knowledge about the subject, not their background or personal experiences.
Example: Question: "Which of the following is a traditional Christmas meal?" This question assumes that every test-taker celebrates or is familiar with Christmas traditions, which may not be the case. Such a question would put those unfamiliar with Christmas at a disadvantage.
INTERMEDIATE Information
Bias & Its Impact on Assessment: Biased questions can affect the validity of a test by not measuring what they are supposed to measure. Instead, they might measure a test-taker's cultural or personal familiarity with the biased content.	READ SMARTER BALANCED ASSESSMENT CONSORTIUM: Bias and Sensitivity Guidelines
Identifying Bias: Bias in medical MCQs can appear subtly. It could be in the form of stereotypical roles, cultural assumptions, or even in the selection of images that are not diverse.
Clinical Scenario with Bias: Question: "A female patient comes to you concerned about weight gain, which contraceptive method is she most likely using?" This question assumes that only females are concerned about weight gain and that such concerns are directly linked to contraceptives. This introduces gender bias and a stereotype.
ADVANCED Information
Consequences of Biased Questions in Medical Education: Distorted Test Results: Biased questions can lead to inaccurate evaluations, meaning students might be marked down not because of a lack of knowledge but because of unfamiliarity with a cultural reference or stereotype. Inequity: Students from diverse backgrounds might feel marginalized or disadvantaged if they consistently encounter test content that doesn't reflect their experiences or realities. Professional Implications: In medical practice, understanding and respecting diversity is crucial. Biased test items can perpetuate stereotypes and hinder the cultivation of culturally competent healthcare professionals.	READ Battling Biases: How Can Diverse Students Overcome Test Bias on the Multistate Bar Examination
Effective Strategies for Avoiding Bias: Diverse Review Panels: Engage a diverse group of educators to review questions for potential biases. Cultural Sensitivity Training: Ensure those who create test items have training in recognizing and eliminating bias. Feedback Mechanisms: Allow students to report potentially biased questions after tests, and take their feedback seriously.
Complex Clinical Scenario Without Bias: Question: "A patient presents with complaints of fatigue, weight gain, and constipation. Lab results show elevated TSH levels. What is the most likely diagnosis?" a) Hyperthyroidism b) Hypothyroidism c) Type 2 Diabetes d) Vitamin B12 deficiency This question focuses purely on the medical information, ensuring that it is free from any cultural, gender, or other biases.
In conclusion, creating unbiased MCQs is not just about fairness in assessment but also about preparing future physician assistants to provide equitable and culturally competent care. Biases, even unintentional ones, in educational materials can have long-term effects on the professional attitudes and behaviors of medical practitioners. As such, meticulous care should be taken to craft questions that are both informative and impartial.

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WEEK 3: Selected Response Items (30 OF 34) Vb. Best Practices in Writing MCQs E. Distractors 2) Avoid using distractors that are humorously wrong or vastly out of scope.	WEEK 3: Selected Response Items (32 OF 34) Vb. Best Practices in Writing MCQs G. Answer Position 1) Randomize the correct answer position among the options to avoid patterns.
REFERENCES ChatGPT1 was used to generate most of the textual aspects of this page, as well as the HTML code, which were then checked for quality and corrected as necessary. Midjourney Bot (in Discord) and Canva were used to generate images 1. ChatGPT. Version 4. OpenAI; 2023. Accessed August, 2023. OpenAI.com 2. Midjourney. Version 5.2. Midjourney; 2013. Accessed August, 2023. Midjourney.com 3. Discord. Discord, Inc.; 2023. Accessed August, 2023. Discord.com 4. Canva. Canva Pty Ltd; 2023. Accessed August, 2023. Canva.com