Multiple Choice Item (MCI) Quick Reference Guide NURS 5328 Tracy Nash, Holly Northcutt, Robin Roberts, Cheryl Sheffield, & Elizabeth Tilley General Writing Guidelines Guidelines for Writing Good Alternatives/Options Considerations for Writing Critical Thinking MCIs • Make all answers grammatically similar • Each answer should have the same number of parts. • All alternative/options should sample the same domain (i.e., assessment finding, diagnostics, or other). • If repeating words in each alternative/option, move those words to the stem. • If the stem is a sentence or a question, end it with the appropriate terminal punctuation. • Ranges in values should not overlap each other. • Make sure each choice is numbered or lettered. • Avoid using “none of the above” or “all of the above.” • If asked to choose the “best” answer there must be scientific evidence to support it. • Keep succinct: shorter than 1 line; shorter than stem • Number of options -Four options reduce the chance of guessing, but use three options if you can’t come up with a fourth plausible option. ○ Plus side of three options - reduces reading time, covers a wider range of content, and increases validity of the test. • Place those with a value in numerical, chronological, or sequential order (ascending or descending). • Positive statements- avoid negativity; avoid double negatives = impossible confusion. • Retain information in the stem and avoid overlapping. • Homogeneous appearance- Alternatives/options should be equally attractive, meaning parallel in length, grammatical structure, content, and complexity. If use opposite options consider: ○ Rule of Two Sets - two sets of opposites attract the uninformed student to all four options). Use medical terminology and technical language consistently. Sequential Reasoning • This is the key to writing questions that require critical thinking • Requires two logical steps: remember then analyze (students must apply their knowledge) • Lower levels of cognition require only memorization Writing Original Critical Thinking Items • Must apply sequential reasoning • Identify the competency and course objective Novel Problems • If students are presented with a higher level problem, yet they are familiar with the problem the question is still a recall item • Do not convert a situation used in class into a test question • The more unique the question, the more critical-thinking is involved   Follow these general rules when writing test items: • Every item should measure something important. • Every item should have a correct answer. • Use simple, clear, concise, grammatically correct language; eliminate unnecessary information • Avoid jargon, slang, and unnecessary abbreviations. • Use positive wording. • Items should not contain irrelevant cues or correct answers. • Ensure each item can stand alone. • Peer critique of test item: Ask colleague critique your questions (Do they agree on the correct answer?) • Prepare more test items than the blue print calls demands. Parts of a Multiple Choice Item (MCI) MCI Format Consists of 2 Parts: 1. The Stem (identifies the problem or question) 2. The Options (presents the response alternative) Also contains a key and distractors. Every test item should represent BOTH course content and a learning outcome. Framing Questions in the Nursing Process Guidelines for Writing Effective Question Stems • Complete – Student should understand what stem is asking before reading the options. • Keep clear and to the point! Use several short sentences if one long sentence is too confusing. Students should be able to read and answer the item in less than one minute. • Do not use the stem to teach. • Eliminate key words that may cue the answer. • Avoid negative wording - If you use a negative word make sure it so it REALLY stands out. • Avoid ending the stem in a incomplete sentence. • If it must be an incomplete sentence; provide alternative answers that would make a complete sentence. • Stay focused – each item should serve one purpose. • Present tense- avoid a passive voice. • Avoid bias and homonyms. • If use the completion format, do not leave a blank at the beginning or middle of a stem. Designing Distractors Plausibility → All distractors must be plausible without being too tricky Misconceptions → Keep log of common misconceptions students express in the clinical setting to create effective distractors Sound bites → Use a distractor that is word for word what is said in class, but is not the answer Seek help → Students must discriminate among appropriately other nurse action items and recognize the need to call the MD Quote the RN/ → Quotes need to represent real life patient situations