Evaluating the quality of multiple-choice questions used for final exams at the Department of Internal Medicine, College of Medicine, King Khalid University

Abstract

Background: The multiple-choice questions (MCQs) part of the final exam in internal medicine at the College of Medicine, King Khalid University is composed of 100 questions of the one best answer type with four options. Although some basic forms of item analysis have been carried out by the department of internal medicine before, the data generated has not been used regularly to assess the quality of the questions or for feedback for the purpose of quality improvement. Aim: The aim of this study was to assess the quality of MCQs used in the final exam in internal medicine during the 1 st week of January 2013. Methods: The total number of the students of this batch was 58, and the total number of MCQs was 100. Item analysis was done using Microsoft Excel 2007. The parameters obtained included difficulty index, discrimination index, point biserial correlation, and reliability of the exam using Kuder-Richardson formula (KR-20), in addition to analysis of distractors. Results: The mean difficulty of the questions was 0.55 (STD = 0.2) and the mean discrimination index was 0.24 (STD = 0.2) with 41 questions having values below 0.20. Regarding point biserial correlation, the mean was 0.16 (STD = 0.12). KR-20 was found to be 0.79; indicating good reliability and the student scores were believed to be reliable. From the 300 distractors assessed, 41% were nonfunctioning. The mean number of functioning distractors per item was 1.76. Conclusion: The MCQs exam was quite reliable, and the difficulty of the questions was reasonable. The discrimination power of most of the questions was acceptable; however, a relatively high proportion of the questions had unacceptable discrimination index values.