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.
Dixon
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RA
Department of Public Health Medicine, University of Sheffield Medical School, UK.
D002755:Choice Behavior; D003657:Decision Making; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000592:standards*; D004739:England; D011634:Public Health