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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Main Authors: L. Britt Wilson, Christine DiStefano, Huijuan Wang, Erika L. Blanck
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
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.
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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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AT erikalblanck comparisonofmultiplechoicequestionformatsinafirstyearmedicalphysiologycourse