Relationship between item difficulty and discrimination indices in true/false-type multiple choice questions of a para-clinical multidisciplinary paper.
BACKGROUND
This paper reports the relationship between the difficulty level and the discrimination power of true/false-type multiple-choice questions (MCQs) in a multidisciplinary paper for the para-clinical year of an undergraduate medical programme.


METHODS
MCQ items in papers taken from Year II Parts A, B and C examinations for Sessions 2001/02, and Part B examinations for 2002/03 and 2003/04, were analysed to obtain their difficulty indices and discrimination indices. Each paper consisted of 250 true/false items (50 questions of 5 items each) on topics drawn from different disciplines. The questions were first constructed and vetted by the individual departments before being submitted to a central committee, where the final selection of the MCQs was made, based purely on the academic judgement of the committee.


RESULTS
There was a wide distribution of item difficulty indices in all the MCQ papers analysed. Furthermore, the relationship between the difficulty index (P) and discrimination index (D) of the MCQ items in a paper was not linear, but more dome-shaped. Maximal discrimination (D = 51% to 71%) occurred with moderately easy/difficult items (P = 40% to 74%). On average, about 38% of the MCQ items in each paper were "very easy" (P > or =75%), while about 9% were "very difficult" (P <25%). About two-thirds of these very easy/difficult items had "very poor" or even negative discrimination (D < or =20%).


CONCLUSIONS
MCQ items that demonstrate good discriminating potential tend to be moderately difficult items, and the moderately-to-very difficult items are more likely to show negative discrimination. There is a need to evaluate the effectiveness of our MCQ items.
Sim
Si-Mui
SM
Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. debrasim@um.edu.my
Rasiah
Raja Isaiah
RI
D000328:Adult; D002755:Choice Behavior; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000379:methods*; D006801:Humans