[CME activities of medical journals: quality of multiple-choice questions as evaluation tool. Using the example of the German medical journals Deutsches Arzteblatt, Deutsche Medizinische Wochenschrift, and Der Internist].
OBJECTIVE
The participation of doctors in Continuing Medical Education (CME) activities provided by medical journals increases. Therefore, their quality and efficacy need to be evaluated.


METHODS
This study evaluated the quality of the multiple-choice questions (MCQs) as evaluation tool of CME activities in three German medical journals (Der Internist, Deutsches Arzteblatt, Deutsche Medizinische Wochenschrift). In total, 390 MCQs were reviewed using evidence-based principles of effective item writing. The content quality of the MCQs was not evaluated in this study.


RESULTS
264 (67.7%) of 390 MCQs contained flaws with 449 flaws in total. The proportion of flawed items was 60.8% in Deutsches Arzteblatt, 63.3% in Der Internist, and 77.9% in Deutsche Medizinische Wochenschrift. The most frequent flaws were clues (33.8%, Deutsches Arzteblatt), negatively worded stems (29.8%, Der Internist), and unfocused stems (24.7%, Deutsche Medizinische Wochenschrift). SCHLUSSFOLGERUNG: The problem of formal flaws in MCQs has an extensive relevance, as seen by the large number of studies related to this topic. The frequency of flaws (67.7%) was similar to recent studies. The distribution of the flaws suggests that with minor editing the quality of the MCQs could be substantially improved.


CONCLUSIONS
The use of high-quality evaluation tools is essential to invalidate the accusation of the trivialization of CME activities, irrespective of their social context.
Kühne-Eversmann
Lisa
L
Medizinische Klinik Innenstadt, Klinikum der Universität München, Ziemssenstrasse 1, 80336, München. Lisa.eversmann@med.uni-muenchen.de
Nussbaum
Claudia
C
Reincke
Martin
M
Fischer
Martin R
MR
D003627:Data Interpretation, Statistical; D004502:Education, Medical, Continuing / Q000592:standards*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008511:Medicine; D010506:Periodicals as Topic / Q000592:standards; D013038:Specialization; D011795:Surveys and Questionnaires