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Writing mc qs for for tbls and pogils nov 5, 2017 class 8

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Writing mc qs for for tbls and pogils nov 5, 2017 class 8

  1. 1. Writing MCQs for for TBLs and POGILs USING THE GUIDELINES FOR NBME QUESTION WRITING
  2. 2. Why use multiple choice questions? Advantages  Versatile  Efficient  Accurate  Reliable  Controllable  Reduces guessing Disadvantages  Difficult to write well  Tendency of author to write recall items only  Influenced by test-savvy responders  Subject to clueing
  3. 3. Terminology used in MCQs Stem The question or statement that precedes answer choices Options Response choices Key The single best correct answer Distractors Incorrect options (not the best choices)
  4. 4. Basic Rules for NBME Question Writing that Apply to TBL and POGIL Rule # 1 - Each item should focus on an important concept rather than something trivial, tricky, or overly complicated  Options should be free of fine distinctions  Avoid options too close to differentiate  Ask, does it pass the “who cares” test?
  5. 5. Basic Rules for NBME Question Writing that Apply to TBL and POGIL Rule # 2 - The stem should pose a clear question  Stem can be long; options should be short, and relatively even in length  To determine if the question is focused, cover up the options and see if the responder can answer the question based only on the stem; if not, rewrite the question  Avoid complete the question or fill in the blank type questions.
  6. 6. Basic Rules for NBME Question Writing that Apply to TBL and POGIL Rule # 3 - All distractors should be homogeneous  They should fall into the same category as the correct answer (i.e, all tests, treatments, diagnoses, prognoses, etc).  All distractors should be plausible, grammatically consistent, logically compatible, and of relatively the same length as the correct answer
  7. 7. Basic Rules for NBME Question Writing that Apply to TBL and POGIL Rule # 4 - Avoid technical flaws that provide benefit to test savvy students or trainees  Do NOT write any questions of the form, “which of the following statements are correct?” or Each of the following are correct EXCEPT ….” These are unfocused and have heterogeneous options.
  8. 8. In general,  Strive for positively worded questions  Negative stems are usually flawed questions  Avoid the use of not, least, except  Negative items are also easily misread  Negative items are equally misread by high and low scoring students  Negative items do not discriminate well between those that know the content and those that do not  Be precise, and avoid indefinite or vague terminology
  9. 9. Frequently used Stems, after setting up the scenario for a question  What is the most likely mechanism of action?  Which of the following is the most likely explanation for these findings?  Which of the following anatomic structures is most likely injured?  Which of the following is most likely to be found on physical exam?  Which of the following laboratory findings will most likely be found?  What is the most likely diagnosis (cause)?  Which of the following diagnostic studies would best confirm the diagnosis?  What complication is likely to occur?
  10. 10. Options should represent the continuum of possible choices B D C E A Least correct Most correct
  11. 11. Use Superlatives  Gives strength to the item  Provide only one best answer  Incorrect options not necessarily "wrong“ but are less desirable
  12. 12. Options Should be Plausible and Homogeneous  Logical and believable  Equally likely to be chosen by a student who does not know the correct answer  Parallel in form, length, amount of detail, and content  Avoid absolutes (there are no absolutes in medicine!)  Similar in content (diagnoses, treatments, physical findings)  Avoid “all of the above” or “none of the above” options
  13. 13. Brain tumors can be detected on imaging: A. Because of mass effect B. Due to their intensity and density differences from the brain C. The presence of edema D. The uptake of IV contrast by the tumor E. All of the above Example of a flawed question Options are not all parallel in grammatical structure or homogeneous, all of above should not be used, and there is no question in the stem
  14. 14. B12 deficiency may be associated with: A . Loss of deep tendon reflexes B . Babinski signs C . Megaloblastic anemia D . All of the above E . A & B only Example of a flawed question
  15. 15. When reviewing MCQs…….  Swap with a colleague to check for:  Gold standard test – cover the options  Check for relevant, applied knowledge  Are all options feasible, plausible?  Is the answer detectable without needing to apply knowledge? If so, too easy to guess
  16. 16. Reference  Online Item writing tutorial is available from the National Board of Medical Examiners at http://download.usmle.org/IWTutorial/intro.htm

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