Abstract
Objectives:To analyze the low to medium distractor efficiency items in a multiple-choice question (MCQ) paper for item writing flaws.Methods:This qualitative study was conducted at Islamic International Medical College Rawalpindi, in October 2019. Archived item- analysis report from a midyear medium stakes MCQ paper of 2nd year MBBS class, was analyzed to determine the non-functional distractors (NFDs) and distractor efficiency (DE) of items, in a total of 181 MCQs. DE was categorized as low (3-4 NFDs), medium (1-2 NFDs) and high (0 NFD). Subsequently, qualitative document analysis of the MCQ paper whose item analysis report was assessed was conducted to investigate the item flaws in the low to medium DE items. The flaws identified were coded and grouped as, within option flaws, alignment flaws between options and stem/ lead-in and other flaws.Results:Distractor efficiency was high in 69 items (38%), moderate in 75 items (42%) and low in 37 items (20%). The item-writing flaws identified in low to moderate DE items within distractors included, non-homogenous length (1.8%), non-homogenous content (8%) and repeat in distractor (1.7%). Alignment flaws between distractors and stem/ lead-in identified were linguistic cues (10%), logic cues (12.5%) and irrelevant distractors (16%). Flaws unrelated to distractors were low cognitive level items (40%) and unnecessarily complicated stems (11.6%).Conclusions:Analyzing the low to medium DE items for item writing flaws, provides valuable information about item writing errors which negatively impact the distractor efficiency.
Highlights
Post hoc item analysis is a commonly used tool to assess the quality of Multiple-choice questions (MCQ) based examinations in undergraduate medical education
Nonfunctional distractors (NFD) were identified as the distractors chosen by less than 5% examinees
A total of 649 distractors were identified in 181 MCQs out of which 205 were nonfunctional distractors (31.6%)
Summary
Post hoc item analysis is a commonly used tool to assess the quality of Multiple-choice questions (MCQ) based examinations in undergraduate medical education. It provides useful information about the reliability and validity of test items. The parameters commonly assessed in item analysis are; the discrimination index (DI), difficulty index and distractor efficiency (DE). Functional or efficient distractors are those, chosen by more than 5% of examinees whereas the distractors chosen by less than 5% examinees are known as non-functional distractors.[1] For distractors to be effective they should all be plausible and if possible, none should be incorrect.[2] The number of non-functional distractors NFDs in an MCQ item
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
