MCQs should consist of a brief stem (clinical scenario) followed by a lead-in question and four response options.
Choices for the MCQ should consist of one best answer and three distractors.
Avoid the following for your MCQ choices and design:
MCQ choices that include “none of the aboce” or “all of the above”.
Combination of choices for answers (e.g., “a and c”).
Questions worded “all of the following are true except …” or “which of the following is NOT correct”.
Any question that uses the word “always” or “never”.
Use of abbreviations.
Use of trade names for medications (e.g., refer to “paroxetine,” not “Paxil”).
Avoid single fact recall questions (e.g., “Which antidepressant has the longest half-life?”)
Make distractor choices for the MCQ plausible and similar in appearance and length to the answer.
Example of a Good MCQ:
A 46-year-old female treated with escitalopram 20 mg daily for major depression presents with confusion, tachycardia, nausea, diaphoresis, diarrhea and clonus. She had recently started a new medication.
Which new medication is most likely the cause of her current symptoms?
