Evaluating and improving multiple choice papers: true-false questions in public health medicine.
The quality of a multiple true-false (MTF) examination paper in public health medicine for 149 clinical medical students was evaluated using predefined performance criteria to offer guidelines for improvement of such a paper. There were 35 questions, each with five true-false branches, and the performance of the overall best 25% of candidates was compared for individual items with that of the overall worst 25%. To improve discrimination between best and worst candidates, 60% of items needed changes, and several indicators were used to identify how, usually because the branch was too easy (26%), unpopular (16%) or too hard (10%). A number of guidelines for writing good MTF questions and for improving them are suggested. The inequity is illustrated of marking systems which do not allocate a negative mark for incorrect answers equal in size to the positive mark for correct ones, with zero for unanswered questions or 'don't know' answers.
Department of Public Health Medicine, University of Sheffield Medical School, UK.
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Dixon
D002755:Choice Behavior; D003657:Decision Making; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000592:standards*; D004739:England; D011634:Public Health