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Writing Meaningful Test Questions

Writing Meaningful Test Questions. Ryan D. Madanick, MD Assistant Professor of Medicine Center for Esophageal Diseases and Swallowing (CEDAS) Division of Gastroenterology and Hepatology University of North Carolina School of Medicine Chapel Hill, NC. Email: madanick@med.unc.edu

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Writing Meaningful Test Questions

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  1. Writing Meaningful Test Questions Ryan D. Madanick, MD Assistant Professor of Medicine Center for Esophageal Diseases and Swallowing (CEDAS) Division of Gastroenterology and Hepatology University of North Carolina School of Medicine Chapel Hill, NC Email: madanick@med.unc.edu Twitter: @RyanMadanickMD Blog: http://gutcheckblog.com Phone: (919) 966-2513 Fax: (919) 843-2508

  2. Learning Objective By the end of this session, learners should be able to: • Create a meaningful 1st order multiple choice question using an objective-based process

  3. Question Components STEM LEAD-IN OPTIONS

  4. Question Components ANSWER OBJECTIVE EXPLANATION

  5. Steps to Writing the MCQ • Determine the objective you are testing • Write the lead-in and options • Draft the stem • Write the explanation (if needed)

  6. Improving the Educational Objective • “Understand peptic ulcer disease” What is wrong with this objective? How could it be improved?

  7. The Objective • Succinct sentence • Specifies a clinical skill to be learned • Uses action verbs to delineate a goal • Recognize, diagnose, treat, manage • Avoid vague action verbs • Remember, recall, know • Allows you to match curriculum

  8. Action Verbs for Objectives

  9. Improving the Educational Objective • “Understand peptic ulcer disease” What is wrong with this objective? How could it be improved? • 1st order: “Diagnose peptic ulcer disease” • 2nd order: “Select the appropriate test for a patient with suspected peptic ulcer disease” • 3rd order: “Explain the mechanism of action for a drug used to treat peptic ulcer disease”

  10. The Lead-In • Keep Lead-In generic • What is the best next step in management? • Use relative terms • What is the most likely diagnosis? • Avoid negative lead lines • Which of the following is the LEAST LIKELY diagnosis? • Watch for syntax/grammar cues • “Cover the options” rule

  11. Options • Avoid mutually exclusive options • Increases/decreases • Always/never; stop/continue • Each option should test one concept • Drug OR dose OR route OR duration • Keep options brief; similar in length • Options should be homogeneous • Length, complexity

  12. The Stem • Chronologic order of presentation • Age, gender (avoid race unless needed) • Site of visit (ER, clinic, hospital) • Chief complaint (add features) • PMH/Meds/FH/SH (relevant or distracter) • Vitals/Exam/Labs/Tests (pertinent)

  13. EXERCISE

  14. Write an objective for a potential test question

  15. Write the lead-in and options for your objective

  16. Draft the stem for your question

  17. Learning Objective By the end of this session, learners should be able to: • Create a meaningful 1st order multiple choice question using an objective-based process Special thanks to Amy Oxentenko, MD for some of these slides

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