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

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

3. 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

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

5. 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

6. 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

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

8. 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

9. 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

10. 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

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

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

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

14. 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

15. 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

16. 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