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MCQ

MCQ. Multiple Choice Questions. Why concern?. ยังคงมีการใช้อยู่ ข้อสอบ comprehensive 4 สถาบัน ข้อสอบ national test แพทยสภา เชียงใหม่ (ดูเหมือนจะ) มีปัญหา ภาควิชาส่วนใหญ่ ไม่มีระบบคัดกรองข้อสอบอย่างจริงจัง สัดส่วนข้อสอบได้รับการคัดเลือกน้อย ผลการสอบของ นศพ. เชียงใหม่ ไม่สวยงามเท่าไรนัก.

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MCQ

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  1. MCQ Multiple Choice Questions

  2. Why concern? • ยังคงมีการใช้อยู่ • ข้อสอบ comprehensive4สถาบัน • ข้อสอบ national testแพทยสภา • เชียงใหม่ (ดูเหมือนจะ) มีปัญหา • ภาควิชาส่วนใหญ่ ไม่มีระบบคัดกรองข้อสอบอย่างจริงจัง • สัดส่วนข้อสอบได้รับการคัดเลือกน้อย • ผลการสอบของ นศพ. เชียงใหม่ ไม่สวยงามเท่าไรนัก

  3. Why still be used? • reliability  • content validity  • practicality 

  4. Why educator hate it? • poor MCQ • validity  • patient doesn’t come with choices! • lower order thinking • recall

  5. First Conclusion • It still be used • National licensing examination • Part I: basic sc 300 items • Part II: clinical sc 450 items • We have to improve ourselves

  6. How to construct? • planning • writing • reviewing and revising • publishing

  7. How to improve? • knowledge • skill • attitude

  8. Basic Knowledge • Theoretically; MCQ = • one best answer, + • matching, + • extended matching, + etc • Practically; • MCQ => one best answer

  9. Planning • identify the outcome • Medical Council Standard • cognitive domain

  10. Cognitive Domain evaluation problem-solving synthesis analysis Application application interpretation comprehensive knowledge recall recall

  11. Planning • identify the outcome • Medical Council Standard • cognitive domain • identify number of item • time => 150 item : 180 min • formula • table of specification

  12. Table of Specification

  13. Table of Specification

  14. Table of Specification

  15. Table of Specification • Cognitive taxonomy ratio • recall : application • basic sciences = 50:50 • body system = 30:70

  16. Planning • identify the outcome • Medical Council Standard • cognitive domain • identify number of item • time => 150 item : 180 min • formula • table of specification

  17. Writing • 1 item = stem + options • stem • options / choices • 1 answer / key • 3-4 distracters • avoid testwiseness • avoid irrelevant difficulty

  18. Good Stem • Valid • What? => TMC standard • Which aspect? => Form • How deep? => For GP

  19. Good Stem • avoid • trivial fact • color reagent • enzyme • extreme recall • the second most common • the least common

  20. Good Stem • 1 stem = 1 aspect • No more • What are … and …? • Usually long stem + short options • Don’t teach in the test!

  21. Good Stem • 1 stem = 1 aspect • No more • What are … and …? • Usually long stem + short options • Don’t teach in the test!

  22. Good Stem • Vignette + leading question Item template : Gross anatomy A (patient description) is unable to (functional disability). Which of the following is most likely to have been injured? A 65-year-old man has difficulty rising from a seated position and straightening his trunk, but he has no difficulty flexing his leg. Which of the following muscles is most likely to have been injured?

  23. Good Stem Item template : A (patient description) has (history findings) and is taking (medications). Which of the following medications is the most likely cause of his (one history, PE or lab finding)? Item template : A (patient description) has a (type of injury and location). Which of the following structures is most likely to be affected?

  24. Good Stem Item template : A (patient description) has (abnormal findings). Which [additional] finding would suggest/suggests a diagnosis of (disease 1) rather than (disease 2)? Item template : A (patient description) dies of (disease). Which of the following is most likely finding on autopsy?

  25. Good Stem A patient has (abnormal findings) but (normal findings). Which of the following is the most likely diagnosis? Item template : A patient has(symptoms and signs).Which of the following is the most likely explanation for the (findings)?

  26. Good Stem • Series of stems are fine • BUT independent

  27. Good Stem • Should not • What do you think?

  28. Good Stem • allow data gathering • provide a sizable data base • simulate reality • include appropriate “noise” • start with problem, not a diagnosis • use unfamiliar (not uncommon) case • test only cognitive objective • avoid diagnostic label

  29. Good Options • same direction • similar length, otherwise • long answer + short distracters • similar style, otherwise • nice answer (copy from textbook) + poor distracters

  30. Good Distractors • incorrect! • reasonable • common misunderstanding • common mistakes

  31. Options Tidiness • sequencing • alphabetical • length • chronological • logical • word repeated

  32. Testwiseness • grammatically guide • totally, absolutely, none, etc • latin translation • all of above, none of above, K type • question A => answer of question B

  33. Unawares, the answer • is usually the option which is • longest • looked nicest • most understandable • appeared most frequent

  34. Irrelevant difficulty • poor written, poor chart • double negative • too long, too complicated • difficult vocabulary, jargon • unordered number • subjective : often, usually • tricky

  35. How to construct? • planning • writing • reviewing and revising • self-test • pilot / colleagues • publishing • readable

  36. How to improve? • Knowledge • Skill • Attitude

  37. Skill • Practicing • Form • Item development team • Item analysis

  38. Miscellaneous • AI • p • r • item sequencing

  39. Conclusion • Knowledge • Skill • Attitude

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