ArticleBDJ open2026
Evaluating single-best-answer questions in dental materials education: a retrospective item analysis from an online undergraduate dentistry question bank.
Article in BDJ open, 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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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh-quality single-best-answer (SBA) questions require appropriate construction, alignment with intended learning outcomes, absence of technical item flaws and psychometric evaluation. Dentistry-specific evidence linking these constructional features to item performance remains limited. This study analysed Dental Materials responses from DentTest, an online undergraduate dentistry question bank, to identify item characteristics associated with higher discrimination.
methodsA retrospective learning-analytics item analysis was performed using first-attempt response data. At extraction, 134 users were eligible, of whom 76 provided research consent (56.7%). The dataset contained 44,964 user×item observations from 76 users across 1560 Dental Materials items. Primary analyses were restricted to 691 items with ≥30 unique first-attempt users. Analyses included item psychometric parameters (facility, discrimination index, number of functioning distractors and distractor entropy) and selected constructional features (option-length cueing, stem word count and negative-stem wording).
resultsDiscrimination index was inversely correlated with facility (r = -0.471; 95% CI -0.527 to -0.411). In the multivariable quadratic model, the estimated peak discrimination occurred at p = 0.578, consistent with an inverted-U relationship between facility and discrimination. Functioning distractors (r = 0.531; 95% CI 0.475-0.582) and distractor entropy (r = 0.471; 95% CI 0.411-0.527) were positively associated with discrimination index. However, split-half stability was low (r = 0.15), with 542/691 items (78.4%) changing discrimination band at least once across repeated splits.
conclusionIn this formative dentistry question bank, Dental Materials SBAs with higher discrimination were associated with moderate facility, stronger distractor functioning and more informative distractor-choice patterns. Item analytics should be viewed as an early-warning system rather than a final judgement, guiding educators towards items that require revision.
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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.