Writing test questions is a critically important and challenging skill. Unfortunately, few instructors have been taught how to design assessments or write test questions. Well written tests motivate students, reinforce learning, and assess content mastery. A good test provides feedback on teaching and helps identify poorly communicated information or critical bottlenecks. Sadly, poorly written tests not only frustrate students, they can actually be a learning detriment as students may focus on the wrong content or ineffective, short-term study strategies. As you construct your tests, consider what types of questions are most appropriate for your content. The idea is to test the students’ mastery of content, not how well they can take a test. Each type of question has its own advantages and disadvantages. Multiple Choice Short Answer Essay or Long Answer Multiple choice questions are versatile because they can test factual recall as well as levels of understanding, synthesis, analysis, and application of learning. Multiple choice questions, however, are also one of the most difficult types of questions to write. A multiple choice question is constructed from a problem or question, known as the stem, and list of suggested answer choices, known as alternatives. The alternatives include one correct or best alternative, which is the answer, and incorrect or inferior alternatives, known as distractors (Clay, 2001). Since questions and alternatives can sometimes be misleading, consider having a colleague take the test before your students do. One way to construct multiple choice questions that require deeper level of thinking is to create a scenario. Provide a description of a situation, a series of graphs or other data that would be appropriate to your discipline. Then, develop a series of questions that relate back to that material. These questions can require students to apply concepts, combine data, make a prediciton or diagnosis, analyze relationships between data or synthesize information. Use questions which encourage evaluation of “higher order” thinking such as interpretation, analysis and synthesis, not just simple recall of medical facts (Loo, 2017). Which of the following types of cells lack functioning mitochondria? The absence of which of the following is the most likely explanation for why a mature red block cell (RBC) is unable to carry out beta-oxidation of fatty acids? The use of tables and figures facilitates “higher order” thinking questions (Loo, 2017). Which of the following pulmonary function tests is most consistent with a patient with idiopathic pulmonary fibrosis (IPF)? FEV1 = Forced expiratory volume in 1 second; FVC = Forced vital capacity; TLC = Total lung capacity; Essay or short-answer questions are the easiest to write, but the most time consuming to grade. Use these types of questions when you want to assess the students’ ability to organize knowledge, give an opinion, or use original thinking. Due to the high probability of guessing, true/false questions are not reliable and not recommended (Case & Swanson, 2002). They are also surprisingly difficult to write because they must be phrased in absolute terms. For more information or support contact: facultydevelopment@medsch.ucr.edu.Question Type Advantages Disadvantages True/False
Not recommended.Tips on Testing
Writing Multiple Choice Questions
Writing an Effective Stem
Writing Effective Alternatives
Example of a recall question of a medical fact:
Example of a question that requires an explanation or interpretation:
Example of a question requiring integration and synthesis:
FEV1 FVC FEV1/FVC TL CDLCO a 58% 62% 70% 68% 64% b 52% 80% 70% 110% 65% c 55% 87% 70% 100% 88% d 57% 82% 70% 70% 68% c 66% 72% 70% 75% 66%
DLCO = Diffusion lung capacity for carbon monoxideWriting Essay or Short-Answer Questions
Writing True/False Questions
References
Writing Effective Test Questions (2024)
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