ArticleKorean journal of medical education2026
Exploring the length and time related concepts for scenario-based multiple-choice questions through perspectives of medical education experts: a mixed-method approach.
Article in Korean journal of medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThere is a substantial gap in the scientific literature about specific, evidence-based guidelines for optimal word count (length) in multiple-choice question (MCQ) "stems" and "options" and validated time management strategies for MCQ test-takers. This dearth of research indicates a potential need for more studies to develop and validate these significant aspects of MCQ assessment and strategy. This was the first study which formulated guidelines for the word count of scenario-based MCQ (SB-MCQ) "stems" and "options," along with justifications, from the perspective of medical education experts. The present research also developed specific, validated time management guidelines to assist test-takers effectively navigate MCQ examination.
methodsA mixed-methods design was implemented where quantitative data from a validated structured questionnaire and qualitative (focus group discussion) data were collected from 76 medical education professionals across multiple Indian provinces, and then analyzed using SPSS and NVivo software.
resultsA recommended best practice for writing SB-MCQs was reported to have question stems between 35-50 words followed by 20-35 words, with three-option formats being preferred over four and five options. Nearly 92.73% of participants reported that, during 1-minute timeframe, maximum time must be spent on "analyzing question stem" followed by on "eliminating options." The study developed succinct, "eight-step guide" to empower test-takers complete MCQ tests proficiently.
conclusionScenario based MCQs with stems between 35-50 words and options between 1-10 words can improve item quality. Three-option MCQs can be preferred over four- or five-option formats. An emerged "eight-step structured guide" can assist test takers to tackle multiple-choice tests more efficiently and effectively.
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