October 3rd and 4th, 2013

Presented by Mary Frances Ypma-Wong, Ph.D.

For the classroom and examinations

Created by Mary Frances Ypma-Wong, Ph.D. along with the Student/Faculty Teaching Enrichment Task Force

1. Identify and construct the 3 components of a good exam question.

2. Avoid five common errors in question writing.

3. Employ two common templates for writing questions.

4. Critique and revise example exam questions.

5. Utilize resources with USMLE questions.

Adapted from NBME Constructing Written Test Questions For the Basic and

Clinical Sciences, 3rd edition http://www.nbme.org/pdf/itemwriting_2003/2003iwgwhole.pdf

and NBME podcast http://download.usmle.org/IWTutorial/Practice.htm

Communicate to students what material is important

Motivate students to study

Identify areas of student deficiency in need of remediation or further learning

Determine final grades or make promotion decisions

Identify areas where the course/curriculum is weak

Stem= Clinical Vignette and Lead-in

Options= Answer + Distractors

D C A E B

Least Correct Most Correct

Basic Science Example

Original Question (simple recall): What area is supplied with blood by the posterior inferior cerebellar artery? (answer = cerebellum)

Revised with Stem and Lead-in (application of knowledge):

A 62-year-old man develops left-sided limb ataxia, Horner’s syndrome, nystagmus, and loss of appreciation of facial pain and temperature sensations. What artery is most likely to be occluded?

Basic Science/Clinical Example

Original Question (simple recall): Which of the following organisms produces beta-hemolysis?

(S. aureus)

Revised with Stem and Lead-in (application of knowledge):

A 25-year-old woman with a history of IV drug use presents herself at the emergency department with high fever, chills and multiple skin lesions at injection sites. A blood culture shows yellow colonies with beta-hemolysis on sheep blood agar. Which pathogen has most likely caused her illness?

What disorder causes a child to be afraid of leaving his parent?

A. Childhood schizophrenia

B. Normal concerns of latency-age children

C. Separation anxiety disorder

D. Socialized conduct disorder

E. Symbiotic psychosis

An 8-year-old-boy needs to be coaxed to go to school, and often, while there, complains of stomach pains so his mother is called to take him home. At night he tried to sleep with his parents and insists there are monsters in his room. These finding are most consistent with which of the following diagnosis?

A. Childhood schizophrenia

B. Normal concerns of latency-age children

C. Separation anxiety disorder

D. Socialized conduct disorder

E. Symbiotic psychosis

Toxigenic food poisoning is caused by:

A. Escherichia coli

B. Proteus mirabilis

C. Salmonella typhimurium

D. Staphylococcus aureus

E. Streptococcus faecalis

At a banquet, the menu included fried chicken, peas, chocolate éclairs , and coffee. Within 2 hours, most of the diners become violently ill, with nausea, vomiting, and abdominal pain. Analysis of the contaminated food is most likely to yield large numbers of which of the following organisms?

A. Escherichia coli

B. Proteus mirabilis

C. Salmonella typhimurium

D. Staphylococcus aureus

E. Streptococcus faecalis

A. collagen

B. corticosteriod

C. fatty acid

D. glucose

*E. heme

A. collagen

B. corticosteriod

C. fatty acid

D. glucose

*E. heme

Diagnosis-Acute intermittent porphyria

Allow for “test wiseness”

Unnecessarily complicate, thus

confuse the test taker

1. Grammatical Clueing

2. Logical Clueing

3. Use of Absolute Terms

4. Word Repeats/Clanging

5. Convergence Strategy

6. Correct answer is the longest- “teaching

moment”

Make answers parallel

1. Unnecessarily long stem

2. Overlapping Options

3. Numeric data is not stated consistently

4. Options are in illogical order

5. Options are long, complicated

6. Frequency terms are vague

7. Use of “all/none of the above”

1. Unnecessarily long stem

2. Overlapping Options

3. Numeric data is not stated consistently

4. Options are in illogical order

5. Options are long, complicated

6. Frequency terms are vague

use of rarely, frequently…

7. Use of “all/none of the above”

USMLE Site

UC Irvine library

Kaplan

USMLE World

McGraw Hill

Amazon

Students themselves

Suggestions?

http://download.usmle.org/IWTutorial/Practice.htm

NBME Subject Exams (moving towards web-based)

Digital Question Bank with analytics?

Contact Mary Frances Ypma-Wong

at 824-2029 or mypmawon@uci.edu