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      Item and Test Analysis to Identify Quality Multiple Choice Questions (MCQs) from an Assessment of Medical Students of Ahmedabad, Gujarat

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          Abstract

          Background:

          Multiple choice questions (MCQs) are frequently used to assess students in different educational streams for their objectivity and wide reach of coverage in less time. However, the MCQs to be used must be of quality which depends upon its difficulty index (DIF I), discrimination index (DI) and distracter efficiency (DE).

          Objective:

          To evaluate MCQs or items and develop a pool of valid items by assessing with DIF I, DI and DE and also to revise/ store or discard items based on obtained results.

          Settings:

          Study was conducted in a medical school of Ahmedabad.

          Materials and Methods:

          An internal examination in Community Medicine was conducted after 40 hours teaching during 1 st MBBS which was attended by 148 out of 150 students. Total 50 MCQs or items and 150 distractors were analyzed.

          Statistical Analysis:

          Data was entered and analyzed in MS Excel 2007 and simple proportions, mean, standard deviations, coefficient of variation were calculated and unpaired t test was applied.

          Results:

          Out of 50 items, 24 had “good to excellent” DIF I (31 - 60%) and 15 had “good to excellent” DI (> 0.25). Mean DE was 88.6% considered as ideal/ acceptable and non functional distractors (NFD) were only 11.4%. Mean DI was 0.14. Poor DI (< 0.15) with negative DI in 10 items indicates poor preparedness of students and some issues with framing of at least some of the MCQs. Increased proportion of NFDs (incorrect alternatives selected by < 5% students) in an item decrease DE and makes it easier. There were 15 items with 17 NFDs, while rest items did not have any NFD with mean DE of 100%.

          Conclusion:

          Study emphasizes the selection of quality MCQs which truly assess the knowledge and are able to differentiate the students of different abilities in correct manner.

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          Most cited references14

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          A tool for self-assessment of communication skills and professionalism in residents

          Background Effective communication skills and professionalism are critical for physicians in order to provide optimum care and achieve better health outcomes. The aims of this study were to evaluate residents' self-assessment of their communication skills and professionalism in dealing with patients, and to evaluate the psychometric properties of a self-assessment questionnaire. Methods A modified version of the American Board of Internal Medicine's (ABIM) Patient Assessment survey was completed by 130 residents in 23 surgical and non-surgical training programs affiliated with a single medical school. Descriptive, regression and factor analyses were performed. Internal consistency, inter-item gamma scores, and discriminative validity of the questionnaire were determined. Results Factor analysis suggested two groups of items: one group relating to developing interpersonal relationships with patients and one group relating to conveying medical information to patients. Cronbach's alpha (0.86) indicated internal consistency. Males rated themselves higher than females in items related to explaining things to patients. When compared to graduates of U.S. medical schools, graduates of medical schools outside the U.S. rated themselves higher in items related to listening to the patient, yet lower in using understandable language. Surgical residents rated themselves higher than non-surgical residents in explaining options to patients. Conclusion This appears to be an internally consistent and reliable tool for residents' self-assessment of communication skills and professionalism. Some demographic differences in self-perceived communication skills were noted.
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            Three Options Are Optimal for Multiple-Choice Items: A Meta-Analysis of 80 Years of Research

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              Analysis of one-best MCQs: the difficulty index, discrimination index and distractor efficiency.

              To investigate the relationship of items having good difficulty and discrimination indices with their distractor efficiency to find how 'ideal questions' can be affected by non-functioning distractors (NF-Ds). The cross-sectional study was conducted at Fatima Jinnah Dental College, Karachi, during Jan-Jun 2009, with 102 First Year dental students (17-20 years). Physiology paper of the first semester, given after 22 weeks of teaching general topics of physiology, was analysed. The paper consisted of 50 one-best MCQs, having 5 options each. The MCQs were analysed for difficulty index (p-value), discrimination index (DI), and distractor efficiency (DE). Items having p-value between 30-70 and DI > or = 0.25 were considered as having good difficulty and discrimination indices respectively. Effective distractors were considered as the ones selected by at least 5% of the students. The mean score was 27.31 +/- 5.75 (maximum 50 marks). Mean p-value and DI were 54.14 +/- 17.48 and 0.356 +/- 0.17, respectively. Seventy eight per cent items were of average (recommended) difficulty (mean p-value = 51.44 +/- 11.11) and having DE = 81.41%. Sixty two per cent items had excellent DI (0.465 +/- 0.083) with DE = 83.06%. Combining the two indices, 32 (64%) items could be called as 'ideal' (p-value = 30 to 70; DI > 0.24) and had DE = 85.15%. Overall 42% items had no Non-functioning Distractors (NF-D), while 12% had 3 NF-Ds. Excellent discrimination (DI = 0.427) was achieved with items having one NF-D, while items with 2 NF-D and no NF-D had nearly equal but lower DI (0.365 and 0.351 respectively). One-best MCQs having average difficulty and high discrimination with three functioning distractors should be incorporated into future tests to improve the test score and properly discriminate among the students. Items with two NF-Ds, though easier, are better discriminators than items with no NF-D.
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                Author and article information

                Journal
                Indian J Community Med
                Indian J Community Med
                IJCM
                Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine
                Medknow Publications & Media Pvt Ltd (India )
                0970-0218
                1998-3581
                Jan-Mar 2014
                : 39
                : 1
                : 17-20
                Affiliations
                [1]Department of Community Medicine, Gujarat Medical Education and Research Society Medical College, Sola, Ahemdabad, Gujarat, India
                Author notes
                Address for correspondence: Dr. Pradeep Kumar, A 1/7, Swagat City, Adalaj, Gandhinagar-382 421, Gujarat, India. E-mail: drpkumar_55@ 123456yahoo.com
                Article
                IJCM-39-17
                10.4103/0970-0218.126347
                3968575
                24696535
                72218176-1d17-4570-a6fc-88718a886edb
                Copyright: © Indian Journal of Community Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 May 2013
                : 23 July 2013
                Categories
                Original Article

                Public health
                difficulty index,discrimination index,distractor efficiency,multiple choice question or item,nonfunctional distractor (nfd),teaching evaluation

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