Physician assistant (PA) educators are tasked with the challenging privilege of ensuring future PAs are knowledgeable and competent to practice medicine. Most enter academia without formal education in providing education. They learn as they go-a treacherous and steep learning curve. This study provides PA educators literature and skills to bolster the strength and validity of multiple-choice examination items to measure learner progress and identify knowledge gaps. Skills can be improved at the level of the individual educator and program or institution. Approaching item writing and item revision in a stepwise, evidence-based manner can improve the quality of the items, strengthening multiple-choice examinations. This process can yield improved assessments of students' medical knowledge and competence. This study aims to provide the PA educator with techniques to improve their item-writing skills.
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