Training Medical Students to Create and Collaboratively Review Multiple-Choice Questions: A Comprehensive Workshop.

Introduction: Multiple-choice question (MCQ) creation is an infrequently used active-learning strategy. Previous studies demonstrated that medical students find value in the process, but have minimal training, which may limit potential learning benefits. We therefore developed a process for question-creation that required students to complete in-depth training, in addition to collaborative question-writing and editing.

Methods: We created a question-writing workshop consisting of three components: (1) training in MCQ writing utilizing NBME online modules, a practice MCQ-writing session, and a training session, (2) writing MCQs independently after choosing topics from an institutionally generated blueprint, and (3) reviewing and editing MCQs via an in-person session. To understand students' perceptions, we held two four-student focus groups and recorded/transcribed the data. We iteratively reviewed the transcripts to generate a codebook and corresponding themes. We used the focus group data to generate a survey with Likert-scale questions, which we sent to the remaining 10 students and analyzed using Microsoft Excel.

Results: Eighteen second-year medical students participated in this workshop. Students perceived that question-writing training (3.7/5.0±0.5) and question writing (3.9/5.0±0.3) benefitted their learning. Students perceived that MCQ writing required concept integration (4.1/5.0±0.6). Students described how question writing allowed them to recognize subtle distinctions between therapies and diagnoses. Each MCQ required about 1.5 hours to write and collaboratively edit.

Discussion: Our results demonstrated that students perceived question writing to benefit their learning. More importantly, students felt that question writing actively engaged them to integrate content and compare concepts; students' engagement suggests that they learned from this question-writing activity.