The Impact of item flaws, testing at low cognitive level, and low distractor functioning on multiple-choice question quality

BACKGROUND This study investigated the impact of addressing item writing flaws, testing at low cognitive level and non-functioning distractors (< 5 % selection frequency) in multiple-choice assessment in preclinical medical education. METHOD Multiple-choice questions with too high or too low difficulty (difficulty index < 0.4 or > 0.8) and insufficient… (More)