Impact Measurement on Medical Faculty for Adhering to Appropriate Guidelines in Framing Effective Multiple-Choice Questions for Item Analysis

Abstract

Background: Multiple-choice questions (MCQs) are the most frequently accepted tool for the evaluation of comprehension, knowledge, and application among medical students. In single best response MCQs (items), a high order of cognition of students can be assessed. It is essential to develop valid and reliable MCQs, as flawed items will interfere with the unbiased assessment. The present paper gives an attempt to discuss the art of framing well-structured items taking kind help from the provided references. This article puts forth a practice for committed medical educators to uplift the skill of forming quality MCQs by enhanced Faculty Development programs (FDPs). Objectives: The objective of the study is also to test the quality of MCQs by item analysis. Methods: In this study, 100 MCQs of set I or set II were distributed to 200 MBBS students of Late Shri Lakhiram Agrawal Memorial Govt. Medical College Raigarh (CG) for item analysis for quality MCQs. Set I and Set II were MCQs which were formed by 60 medical faculty before and after FDP, respectively. All MCQs had a single stem with three wrong and one correct answers. The data were entered in Microsoft excel 2016 software to analyze. The difficulty index (Dif I), discrimination index (DI), and distractor efficiency (DE) were the item analysis parameters used to evaluate the impact on adhering to the guidelines for framing MCQs. Results: The mean calculated difficulty index, discrimination index, and distractor efficiency were 56.54%, 0.26, and 89.93%, respectively. Among 100 items, 14 items were of higher difficulty level (DIF I < 30%), 70 were of moderate category, and 16 items were of easy level (DIF I > 60%). A total of 10 items had very good DI (0.40), 32 had recommended values (0.30 - 0.39), and 25 were acceptable with changes (0.20 - 0.29). Of the 100 MCQs, there were 27 MCQs with DE of 66.66% and 11 MCQs with DE of 33.33%. Conclusions: In this study, higher cognitive-domain MCQs increased after training, recurrent-type MCQ decreased, and MCQ with item writing flaws reduced, therefore making our results much more statistically significant. We had nine MCQs that satisfied all the criteria of item analysis.