An investigation into the optimal number of distractors in single-best answer exams.

In UK medical schools, five-option single-best answer (SBA) questions are the most widely accepted format of summative knowledge assessment. However, writing SBA questions with four effective incorrect options is difficult and time consuming, and consequently, many SBAs contain a high frequency of implausible distractors. Previous research has suggested that fewer than five-options could hence be used for assessment, without deterioration in quality.

Student-written single-best answer questions predict performance in finals.

Background: Single-best answer (SBA) questions are widely used for assessment in medical schools; however, often clinical staff have neither the time nor the incentive to develop high-quality material for revision purposes. A student-led approach to producing formative SBA questions offers a potential solution.

Methods: Cardiff University School of Medicine students created a bank of SBA questions through a previously described staged approach, involving student question-writing, peer-review and targeted senior clinician input.

A novel student-led approach to multiple-choice question generation and online database creation, with targeted clinician input.

Problem: Multiple-choice questions (MCQs) are the main method of assessing medical student knowledge. As a result there is a high demand from medical students for formative MCQs. However, teaching staff rarely have the time or incentive to develop high-quality formative questions, focusing instead on material for high-stakes assessments.