Tips for Constructing Multiple Choice Questions (MCQs)
- 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”).
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?
- a) Methylphenidate
- b) Lithium
- c) Bupropion
- d) Lorazepam