ArticleCureus2024
Item Analysis of Multiple-Choice Question (MCQ)-Based Exam Efficiency Among Postgraduate Pediatric Medical Students: An Observational, Cross-Sectional Study From Saudi Arabia.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Analyzing Test Items Using Difficulty Index and Discrimination Index for Evaluating Postgraduate Medical Residents.Cureus · 2026Article
- Development of a pain management competency assessment for physiotherapy students: Integrating simulation and written assessments.Canadian journal of pain = Revue canadienne de la douleur · 2025Article
- Psychometric Evaluation of Forensic Medicine Multiple-Choice Questions: An Item Analysis From a Nepali Medical College.Journal of medical education and curricular developmentArticle
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral modalities of written examination have been employed in medical education, with multiple-choice questions (MCQs) being the most frequently used and preferred format. This underlines the need to regularly assess and monitor the quality of MCQs in medical exams. Such assessment of MCQs helps to ensure that these exams are well‑designed and adequately powered to evaluate students' performance. Hence, the current study assessed the efficiency of an MCQ-based examination, in a cohort of pediatric post-graduate students in Saudi Arabia.
methodsThis observational, cross-sectional study examined the efficiency of MCQs in terms of their validity, reliability, difficulty index (DFI), discrimination index (DI), and distractor efficiency (DE). The exam consisted of a total of 48 MCQs, 144 distractors, a total score of 48, and no negative marking.
resultsThe reliability index of 0.76 showed the consistency and reproducibility of the exam results. The exam had a DFI of 69.77%, indicating an overall moderate level of difficulty. The exam had a balanced mix of 23 easy (47.9%), 20 (41.7%) moderately difficult, and five (10.4%) tough questions. Twenty (41.6%) items had a DI of ≥0.3, indicating good discrimination of high and low performers, while the remaining 28 MCQs (58.3%) had a lower DI of ≤0.19, implying poor discriminative ability. The DE was 81.25%, indicating that the majority of distractors in the exam were functional.
conclusionTo the best of the author's knowledge, this is the first study among post-graduate pediatric students from Saudi Arabia, to present the results of item analysis of an MCQ-based exam. The study highlights the importance of optimizing the quality of MCQs by following established guidelines, to make MCQ-based clinical assessments more effective. It reiterates the importance of a reasonable DFI well aligned with students' knowledge levels, maximum distractor functionality, and an impactful DI, in developing high-quality MCQs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.