Multiple Choice Questions (MCQ) is one of the most widely used assessment tools in any educational context as it can assess from a wide area of the curriculum with relative ease within a short period of time. This also applies to medical education as it covers a vast area of knowledge and none of the other assessment strategies are geared to assess such vast content at an exam setting.
But, unless the MCQs are prepared in a manner which do not allow the students to guess the answers without needing to know or formulate, if it deliberately makes students to take a wrong choice or else if it do not tally with the intended outcomes of a course of study, it may not serve the purpose. Thus, following tips would be rather useful in making the most effective MCQs in a medical education setting.
Always follow a blue print when preparing the MCQ as it will then cover the areas which it intends to cover in an appropriate proportion. Prepare the stem of the MCQ clear and direct to the student without any fancy language jargon. Keep all the distracters plausible rather than including obviously false distracters. Keep the choices as short as possible and of the same length in almost all instances. Arrange the response items in a logical manner rather than placing them randomly. Avoid using the ‘none of the above’ as an option in the item responses. Place the correct response in all positions throughout the paper in an equal proportion. Be cautions when placing negatives in the question stem and if possible take measures to highlight such negative terms. Make stems in a manner which allows the good student to derive the answer without looking at the options that are given for selection. Use the term ‘best’ instead of ‘correct’ when asking a question. Avoid assessing multiple competencies or knowledge components through a single question as much as possible. Develop a mix of easy and difficult questions throughout the question paper. Re-visit the questions that were made and revise them accordingly in order to formulate the best.
Following formulation of questions, it is a good idea to review the questions in an examination panel or with a trusted colleague in order to minimize ambiguities and to identify obvious errors which may be missed to the eyes of a person who formulates it.
Lastly, the secret to producing more effective and better quality MCQs would be the experience we gain with each time we create such MCQs and the analysis of the results obtained by students facing such MCQs.