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A Guide to Successfully Writing Multiple Choice Questions (MCQs)

Peter G. Mills, Mark A. Westwood, Alfred Tenore

“Examinations are formidable even to the best prepared, for the greatest fool may ask more than the wisest man can answer”

Charles Caleb Colton (1780 – 1832)

The purpose of this review is to provide guidelines that can be used by the UEMS community to assist them in a challenging task of writing effective and high quality MCQs.

In 1956, Benjamin Bloom published a taxonomy of cognitive learning as a hierarchy of knowledge , comprehension , application , analysis , synthesis and evaluation . Through the years, educators have adopted Bloom’s taxonomy for test development and simplified and organized it to include the following three categories:

1) knowledge (recall or recognition of specific information),

2) combined comprehension and application (understanding or being able to explain in one’s own words previously learned information and using new information, rules, methods, concepts, principles, laws and theories), and

3) problem solving (transferring existing knowledge and skills to new situations).

Since the desired outcome of an educational program requires that “learners” do more than recall facts, MCQs should be carefully designed to assess, as much as possible, problem-solving capabilities which increase the validity of the examination.

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