Comparison of Multiple-Choice Question Formats in a First Year Medical Physiology Course
The purpose of this study was to compare student performance and question discrimination of multiple-choice questions (MCQs) that followed a standard format (SF) versus those that do not follow a SF, termed here as non-standard format (NSF). Medical physiology exam results of approximately 500 first...
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Taylor & Francis Group
2024-12-01
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| Series: | Journal of CME |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/28338073.2024.2390264 |
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| author | L. Britt Wilson Christine DiStefano Huijuan Wang Erika L. Blanck |
| author_facet | L. Britt Wilson Christine DiStefano Huijuan Wang Erika L. Blanck |
| author_sort | L. Britt Wilson |
| collection | DOAJ |
| description | The purpose of this study was to compare student performance and question discrimination of multiple-choice questions (MCQs) that followed a standard format (SF) versus those that do not follow a SF, termed here as non-standard format (NSF). Medical physiology exam results of approximately 500 first-year medical students collected over a five-year period (2020–2024) were used. Classical test theory item analysis indices, e.g. discrimination (D), point-biserial correlation (rpbis), distractor analysis for non-functional distractors (NFDs), and difficulty (p) were determined and compared across MCQ format types. The results presented here are the mean ± standard error of the mean (SEM). The analysis showed that D (0.278 ± 0.008 vs 0.228 ± 0.006) and rpbis (0.291 ± .006 vs 0.273 ± .006) were significantly higher for NSF questions compared to SF questions, indicating NSF questions provided more discriminatory power. In addition, the percentage of NFDs was lower for the NSF items compared to the SF ones (58.3 ± 0.019% vs 70.2 ± 0.015%). Also, the NSF questions proved to be more difficult relative to the SF questions (p = 0.741 ± 0.007 for NSF; p = 0.809 ± 0.006 for SF). Thus, the NSF questions discriminated better, had fewer NFDs, and were more difficult than SF questions. These data suggest that using the selected non-standard item writing questions can enhance the ability to discriminate higher performers from lower performers on MCQs as well as provide more rigour for exams. |
| format | Article |
| id | doaj-art-80f2a3f9d5f1436e9261dd59bacaff48 |
| institution | DOAJ |
| issn | 2833-8073 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
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| series | Journal of CME |
| spelling | doaj-art-80f2a3f9d5f1436e9261dd59bacaff482025-08-20T02:48:45ZengTaylor & Francis GroupJournal of CME2833-80732024-12-0113110.1080/28338073.2024.2390264Comparison of Multiple-Choice Question Formats in a First Year Medical Physiology CourseL. Britt Wilson0Christine DiStefano1Huijuan Wang2Erika L. Blanck3Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC, USADepartment of Educational and Developmental Science, College of Education, University of South Carolina, Columbia, SCDepartment of Educational and Developmental Science, College of Education, University of South Carolina, Columbia, SCDepartment of Cell Biology and Anatomy, University of South Carolina School of Medicine, Columbia, SC, USAThe purpose of this study was to compare student performance and question discrimination of multiple-choice questions (MCQs) that followed a standard format (SF) versus those that do not follow a SF, termed here as non-standard format (NSF). Medical physiology exam results of approximately 500 first-year medical students collected over a five-year period (2020–2024) were used. Classical test theory item analysis indices, e.g. discrimination (D), point-biserial correlation (rpbis), distractor analysis for non-functional distractors (NFDs), and difficulty (p) were determined and compared across MCQ format types. The results presented here are the mean ± standard error of the mean (SEM). The analysis showed that D (0.278 ± 0.008 vs 0.228 ± 0.006) and rpbis (0.291 ± .006 vs 0.273 ± .006) were significantly higher for NSF questions compared to SF questions, indicating NSF questions provided more discriminatory power. In addition, the percentage of NFDs was lower for the NSF items compared to the SF ones (58.3 ± 0.019% vs 70.2 ± 0.015%). Also, the NSF questions proved to be more difficult relative to the SF questions (p = 0.741 ± 0.007 for NSF; p = 0.809 ± 0.006 for SF). Thus, the NSF questions discriminated better, had fewer NFDs, and were more difficult than SF questions. These data suggest that using the selected non-standard item writing questions can enhance the ability to discriminate higher performers from lower performers on MCQs as well as provide more rigour for exams.https://www.tandfonline.com/doi/10.1080/28338073.2024.2390264Multiple choiceitem writingfirst-year medical studentphysiologytest development |
| spellingShingle | L. Britt Wilson Christine DiStefano Huijuan Wang Erika L. Blanck Comparison of Multiple-Choice Question Formats in a First Year Medical Physiology Course Journal of CME Multiple choice item writing first-year medical student physiology test development |
| title | Comparison of Multiple-Choice Question Formats in a First Year Medical Physiology Course |
| title_full | Comparison of Multiple-Choice Question Formats in a First Year Medical Physiology Course |
| title_fullStr | Comparison of Multiple-Choice Question Formats in a First Year Medical Physiology Course |
| title_full_unstemmed | Comparison of Multiple-Choice Question Formats in a First Year Medical Physiology Course |
| title_short | Comparison of Multiple-Choice Question Formats in a First Year Medical Physiology Course |
| title_sort | comparison of multiple choice question formats in a first year medical physiology course |
| topic | Multiple choice item writing first-year medical student physiology test development |
| url | https://www.tandfonline.com/doi/10.1080/28338073.2024.2390264 |
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