MEU WORKSHOP

MCQ’S

Objective type questions

Objective type questions

Why MCQ ?

• Objective marking

• Reliability: key, time

• Easy to mark

• Used repeatedly

• Wider sampling of subject matter

• Variety in type of questions

Learning objective

• To identify components of multiple choice questions (MCQ)

• To describe merits and demerits of MCQs

• To frame MCQs

• To evaluate a MCQ

Components

• Item

• Stem

• Distractor

• Key

Components - Item

The drug of choice for treatment of

congestive cardiac failure is

a. Isoptin

b. Digitalis

c. Propranolol

d. Aminophylline

Stem

Key

Distractors

Formats

• Single best response

• Completion type

• Relationship analysis

• True-False completion type

• Matching type

Single best response

• The most effective prophylactic agent for

prevention of rheumatic fever is:

a. ACTH

b. Cortisone

c. Acetyl salicylic acid

d. Para aminobenzoic acid

e. None of the above

Case history analysis

• A 7 yr old presents with cough, fever and

an abnormal chest x ray with bilateral

infiltrates and mantoux test had a 15mm

induration. The most likely diagnosis is

(a) Pneumococcal pneumonia

(b) Pulmonary tuberculosis

(c) Mycoplasma pneumonia

(d) Viral pneumonia

Comments

• Most common format

• Tests recall of facts

• Find possible alternatives/ distractors

• Use of “All of the above”

• Use of “None of the above”

• Errors: grammatical clues, length of

correct response

Comments

• Which are the

following are

diuretics?

• (a) Frusemide

• (b) Thiazide

• (c) Mannitol

• (d) All of the above

• Following contrast

media is used for IVP

except

• (a) Conray

• (b) Urograffin

• (c) Dianosil

• (d) None of the above

Comments

• Most common format

• Tests recall of facts

• Find possible alternatives/ distractors

• Use of “All of the above”

• Use of “None of the above”

• Errors: grammatical clues, length of

correct response

Comments

• Imipramine is an

• (a) Anti depressant

• (b) Bronchodilator

• (c) Sedative

• (d) Stimulant

• Protein content of

100ml of breast

milk is:

• (a) 1gm

• (b) 2gm

• (c) 3gm

• (d) 4.3gm

Multiple completion type

• Live virus is used in immunization against

• (1) Influenza

• (2) Common cold

• (3) Cholera

• (4) Small pox

(a) responses 1,2 and 3 are correct

(b) 1 and 3 are correct

(c) 2 and 4 are correct

(d) Only 4 is correct

(e) All four are correct

Comments

• Tests higher levels of cognition

• Can be used with only four distractors

• Reduces the bias with length of the

alternatives

Relationship Analysis

Cow’s milk is preferable to breast milk for infant

feeding because

Cow’s milk has higher content of calcium

(a) Both statements are true and causally related

(b) Both statements are true but not causally

related

(c) First statement is true and second false

(d) First is false and second is true

(e) Both statements are false

Comments

• Very useful for higher levels of cognition

• Problem with scoring

Multiple true false completion

• Nutritional rickets is associated with

(a) Prominent costochondral junctions

(b) Hemorrhagic tendency

(c) Raise alkaline phosphatase

(d) Nephrocalcinosis

(e) Hypertrophy of gums

Comments

• Most common in UK exams

• Avoid superlative situations: ‘The best

reason for” “ The most acceptable cause”

• No restriction on true or false responses.

• Items may test only recall

• Stem may be too short and implicit

Matching type

• Match the following sites of absorption on

the gut with the nutrients absorbed at each

site;

(a) Jejunum A. Calcium

(b) Terminal ileum B. Water,electrolytes

(c) Colon C. Vit B12

D. Polysaccharides

E. Glycerol

Comments

• Guessing

• Used only to test some areas of subject

Tricks of the trade

• Each item should

test an important learning outcome.

be complete

be independent

be written in a standard format

Item based on a single theme

• In case of sunstroke,the victim:

(a) Should have head lowered

(b) Has a weak pulse

(c) Should be given a stimulant

(d) Should have a cold sponging

Item based on single theme

• The commonest feature of sunstroke is:

(a) Weak pulse

(b) Pale face

(c) High temperature

(d) Excessive sweating

Stem -clear and qualified

• The mandibular nerve:

(a) Is sensory

(b) Supplies buccinator

(c) Is a branch of vagus

(d) Is motor

• The infant mortality rate is:

(a) 40

(b) 80

(c) 100

(d) 120

Stem-avoid negatives

• Clubbing of nails is not associated with:

• The following are not loop diuretics

except:

Options-parallel in content

• Hemolytic anemia is

suggested by:

(a) High alkaline

phosphatase

(b) Reticulocyte count

is high

(c) Platelet is low

(d) Clay stools

• How would you reframe

this item?

Key- the best choice

• The treatment of bronchogenic carcinoma

is

(a) Radiotherapy

(b) Chemotherapy

(c) Surgery

(d) Immunotherapy

Distractor-that distracts nobody!

• Integrated child development program

provides service till the age of:

• (a) I year

• (b) 3 years

• (c) 5 years

• (d) Life long

Options-avoid duplication,

inclusive or exclusive

• Children at what

age are covered

under universal

immunization

program?

• (a) under 5 years

• (b) 0-3years

• (c) 0-5 years

• (d) 1-2years

• What percentage of

Indian children are

malnourished?

• (a) less than 20%

• (b) less than 40%

• (c) more than 40%

• (d) more than 60%

Avoid clues

• In which of the following conditions does

hemolysis pay an important role:

• (a) Albers Schonberg disease

• (b) Megaloblastic anemia

• (c) Henoch Scholein purpura

• (d) Hemolytic uremic syndrome

Reduce guessing

• Avoid subconscious preference to a

particular option….

1.b 2.a 3.d 4.b 5.a 6.d………..

• Avoid reducing distractors

four options are considered satisfactory

Will you like this sequence?

• The average duration of human pregnancy

is:

• (a) 258days

• (b) 280days

• (c) 266days

• (d) 290days

Group Activity

• Please comment on the MCQs given to

you (10mins)

• Please frame 2 MCQs per group with

respect to the subject of your choice (15

mins)

Analysis

• NUMBER OF ITEMS:

60-100 items for 60-90mins

25-30 items inadequate!

• TIME:

One best response :40secs

Multiple true/false: 50secs

Relationship analysis: 50sec

Case history: 90secs

• NEGATIVE MARKING:

Should not equal marks for correct answers

• PASS LEVEL:

Good for ranking rather than deciding pass or fail.

Appearances to the mind……

• Things either are what they appear to be

• They neither are, nor appear to be

• They are and do not appear to be

• They are not, yet appear to be

To aim the right way is the wise man’s task!!

Epictetus,1st century A.D

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