Handling Multiple Choice Questions (MCQ) Dr. C N Sarker Associate Professor & Head of Medicine, MMC

What is MCQ? This is a question where alternatives are given to identify the appropriate answer/answers.

Structure of MCQ Item - whole of an MCQ is called an item Stem - the main part of the item (i.e.. The part that presents the scenario) is called the question stem Lead - in statement - the part of the item that tells the candidates what he has to do Alternative - the answer part of an MCQ

Structure of MCQ - contd.... Key - a correct alternative Distracter - an incorrect alternative

Structure of MCQ - contd.. Examples Lead in statement - e.g.. Write T for true F for false Stem - The following substances are essential for erythropoiesis

Structure of MCQ - contd.. Alternatives a) iron b) folic acid c) nicotinic acid d) vitamin B12 c) myoglobin Key - a, b, d Distracters- c, e

Types of MCQ One best response Multiple true - false Matching type Multiple completion type Reason - Assertion or Relationship analysis type

Example of Multiple True False Lead in statement - i.e. instruction Stem - in the form of question, statement, case history, or clinical data Alternatives - possibilities must be unequivocally true or false (in contrast to single best response) Key - true alternative Distracter - false alternative

One best response type e.g. Lead in statement - select the one best response Stem - deficiency of niacin leads to the development of : Alternative - a) diarrhea b) photophobia c) peripheral neuropathy d) cheilosis Key - a

One best response e.g.. Clinical features of neonatal tetanus include all of the following, except: a) bulging frontanel b) trismus c) hypertonia d) spasms Key - a

Matching type of MCQ Match the following with appropriate statement given below a) lymph node - 1. Contains plasma cells b) spleen 2. Involutes at puberty c) both 3. Has a cortex & medulla d) neither 4. Is the source of T cells Key - 1 - c, 2 - d, 3 - a, 4 - c & d

Assertion - Reason format (relationship analysis) Each item consists of an assertion (statement A) linked to a reason (statement B) by the connecting word because

Advantage & scope of MCQ Can test large sample of knowledge Short period of time Ease of scoring Objectivity or reliability of scoring

Disadvantages of MCQ Not suitable for highest level of Cognitive domain Can’t test ability to write logically & systematically Can’t test capability of expression Can’t test motor skills

Check List for making MCQ Item should deal with all important aspects of the subject Minutiae of medical knowledge should be avoided Daily working knowledge should be applied Level of knowledge expected from the examinee should be appropriate

Check List - contd.. Clear, accurate, & brief statement is logical Alternatives must be grammatically consistent with stem Alternative must be a plausible response Avoid duplication Avoid “none of the above/ all of the above” when each alternative carry equal marks