MCQs Key Features

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MCQsKey Features

• Kichu Nair

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Why Test?

• Powerful motivators
• Students will learn what we believe to be of
  value
• Should have ongoing feedback on performance

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Purpose of testing

• Communicate to students what is important
• Motivate to study
• Identify areas of deficiency
• Remediation
• Determine final grades or promotion
• Identify curriculum weakness

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What should be tested

• Content should match course objectives
• Weighting for important topics
• Time on testing should depend on the importance
  of topic
• Sample of items should represent the
  instructional goals

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Sampling

• Inferences drawn from the exam
• Sample topics
• Sample skills
• Basis for assuming achievement in broader domain
• Reliable and generalizable
• Accurate( valid)

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MCQ formats A type

• Single best response
• Broaden the scope by including clinical vignettes
  problem solving skills and reasoning

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Key Feature

• A clinical problem( age, setting, severe )
• A case followed by questions
• Questions to assess clinical decisions and
  actions
• Questions in relation to critical elements ,
  unique challenges in the resolution of the problem

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Key Features

• Critical or essential
• Where they go wrong
• Most difficult aspects of identification and
  management
• Case specificity
• Assess effectiveness not thoroughness
• Use wide sampling

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Fidelity

• Reliability - focused problems better sampling ,
  more accurate assessment
• Content validity - assess the most important
  clinical decisions within the problems
• Bottom up thinking - what clinicians do in real
  life
• FIDELITY

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The stem

• Must be clear and unambiguous
• the way to a mans heart is through his
  aorta/pulmonary artery/jugular /stomach
• Should be absolutely true or false
• Must avoid imprecise phrases (associated with,
  is useful for, is important or could be)

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Type A

• Which of the following is true about pseudo gout?
• A. occurs frequently in women
• B.seldom associated with acute pain
• C.associated with chondrocalcinosis
• D. hereditary in most cases
• E. responds well to allopurinol

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A type

• Stem
• A 32 year old man has a 4 day history of
  progressive weakness of his extremities. He has
  been healthy except for an upper respiratory
  tract infection 2 weeks ago. His temperature
  is 37.8C, BP is 130/80, pulse is 94/minute and
  resp 42/min and shallow. He has symmetric
  weakness of both sides of his face and the prox
  and distal muscles of the extremities.Sensation
  is intact. No deep tendon reflexes can be
  elicited plantar reflexes are flexor.

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A type

• Lead in- Which of the following is the most
  likely diagnosis?
• Options-
• Acute disseminated encephalomyelitis
• Guillain- Barre Syndrome
• Myasthenia Gravis
• Poliomyelitis
• Polymyositis

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General guidelines

• Can be answered without looking at options
• Long stem and short options
• Avoid superficial information
• Avoid tricky and complex items
• Options in logical or alphabetical order
• Avoid absolutes such as always, never
• Avoid negatively phrased items

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The Bottom Line

• Do not use false/true options
• Best answer can assess application of knowledge,
  integration, synthesis and judgment

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Bottom line

• Focus on important concepts
• Dont waste time on trivial facts
• Frequently and rarely often overlap for
  examiners too!