Multiple true-false items: a comparison of scoring algorithms.

Multiple true-false (MTF) items are a widely used supplement to the commonly used single-best answer (Type A) multiple choice format. However, an optimal scoring algorithm for MTF items has not yet been established, as existing studies yielded conflicting results. Therefore, this study analyzes two questions: What is the optimal scoring algorithm for MTF items regarding reliability, difficulty index and item discrimination? How do the psychometric characteristics of different scoring algorithms compare to those of Type A questions used in the same exams? We used data from 37 medical exams conducted in 2015 (998 MTF and 2163 Type A items overall).