Module 12: Construction of Multiple-choice Tests

10 guidelines for writing good multiple choice items

Most instructors will agree that good multiple-choice questions are both time-consuming to construct and difficult to construct. Some useful hints are offered as guidelines for writing good multiple-choice items.

1. State the main stem in positive language, avoiding "not" and "except" whenever possible. Questions using these negatives should highlight the negative word such as: Which one of the following drugs is NOT effective against gram negative bacteria?
2. Avoid questions that ask "never" and "always."
3. Avoid using "all of the above" and "none of the above".
   This style of question is no longer asked on the National Board exams.
4. For areas of opinion, qualify the stem with "according to……".
5. Vary the position of the correct answer.
6. When possible, keep all options about the same length.
7. Increase similarity of content among options.
8. The stem of the item should pose a definite problem and be meaningful in and of itself.
9. Multiple choice items should have three to five alternatives. Most test experts agree that four alternatives provide adequate discrimination.
10. Numerical answers should be placed in numerical order.

Think of tests you've taken in the past. Can you remember trying to answer test questions that were written with negatives in the stem? Did you find them confusing?