5.2 Multiple choice questions in microcredentials

5.2.1 Multiple choice questions (MCQs)

Multiple-choice questions (MCQs) are a popular assessment tool due to their versatility and capacity for testing a wide range of learning outcomes. Test questions consist of a stem and alternatives, one of which is the answer and the remainder of which are distractors.

Stem	A 54-year-old woman, G0P0, with a BMI of 20, smokes and works as a convenience store clerk. She is seeing you because she has been having urine leakage. Which of the following in her history is a known risk factor for urinary incontinence?
Alternatives		A. BMI	Distractors
		B. Occupation type
		C. Parity
		D. Smoking status	Answer

However, their effectiveness depends largely on how they are designed. Well-designed MCQs share some key characteristics:

Clarity: questions should be clearly written. Avoid any ambiguity that might confuse students and use language that is straightforward and specific to the level of the learners.
Relevance: questions should be related to the learning outcomes of the course. Irrelevant questions can mislead or confuse students, which negatively affects the assessment's validity.
Distractors: distractors are incorrect options. They should be plausible enough to challenge students who do not know the material, while still being clearly distinguishable from the correct answer to those who do know the material.
Single correct answers: questions should have only one clear, correct answer, even though the distractors may seem feasible. This ensures the accuracy and fairness of the assessment.
Avoid trivia: questions should assess students' understanding of key concepts rather than general knowledge or small details. Exceptions can (and should) be made for knowledge that is essential for the learning objectives.
Alignment with ILOs: when designing the questions, it’s important to make sure that the measure and align with specific intended learning outcomes. This alignment will ensure that the ILLOs are met, and it provides feedback to both learners and instructors on general progress and areas of improvement.

5.2.2 Guidelines to writing multiple choice questions

Guidelines for writing the stem:

The stem should…

be meaningful by itself and should present a definite problem.
contain only relevant material.
be negatively stated only when significant learning outcomes require it.
be a question or a partial sentence.
A question stem is preferable.
Stems with beginning and interior blanks should be avoided.

Guidelines for writing alternatives:

Alternatives should…

be plausible.
be stated clearly and concisely.
be mutually exclusive.
be homogenous in content.
not include “all of the above” and “none of the above”
be presented in a logical order (e.g., alphabetical, numerical) to avoid a bias toward certain positions.
be free from clues about which response is correct. Specifically, the alternatives should all
- have grammar consistent with the stem.
- be parallel in form.
- be similar in length.
- use similar language.

Other Guidelines

As long as all alternatives are plausible, the number of alternatives can vary among items. There is little difference in difficulty, discrimination, and test score reliability among items containing two, three, and four distractors.
Avoid complex multiple-choice problems (i.e., alternatives such as 1 and 2; 2 and 3; 1 and 3; 1, 2, and 3).
Keep the specific content of items independent of one another.