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Cited by 196Innovations in Medical EducationEducational Assessment and PedagogyPsychometric Methodologies and Testing

Relationship Between Item Difficulty and Discrimination Indices in True/False-Type Multiple Choice Questions of a Para-clinical Multidisciplinary Paper

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Sim, Si-Mui, Rasiah, Raja Isaiah·2006·Annals of the Academy of Medicine, Singapore
DOI 10.47102/annals-acadmedsg.v35n2p67
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Abstract

Introduction: This paper reports the relationship between the difficulty level and the discrimination power of true/false-type multiple-choice questions (MCQs) in a multidisciplinary paper for the para-clinical year of an undergraduate medical programme. Materials and Methods: MCQ items in papers taken from Year II Parts A, B and C examinations for Sessions 2001/02, and Part B examinations for 2002/03 and 2003/04, were analysed to obtain their difficulty indices and discrimination indices. Each paper consisted of 250 true/false items (50 questions of 5 items each) on topics drawn from different disciplines. The questions were first constructed and vetted by the individual departments before being submitted to a central committee, where the final selection of the MCQs was made, based purely on the academic judgement of the committee. Results: There was a wide distribution of item difficulty indices in all the MCQ papers analysed. Furthermore, the relationship between the difficulty index (P) and discrimination index (D) of the MCQ items in a paper was not linear, but more dome-shaped. Maximal discrimination (D = 51% to 71%) occurred with moderately easy/difficult items (P = 40% to 74%). On average, about 38% of the MCQ items in each paper were “very easy” (P≥75%), while about 9% were “very difficult” (P <25%). About two-thirds of these very easy/difficult items had “very poor” or even negative discrimination (D ≤20%). Conclusions: MCQ items that demonstrate good discriminating potential tend to be moderately difficult items, and the moderately-to-very difficult items are more likely to show negative discrimination. There is a need to evaluate the effectiveness of our MCQ items. Key words: Assessment methods, Educational measurement, Item analysis, Year II medical test

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  • Other authors have reported a significant linear and dome-shaped relationship between difficulty and the discrimination index [6, 56].

    “Other authors have reported a significant linear and dome-shaped relationship between difficulty and the discrimination index [6, 56].”

    From AI in medical education: uses of AI in construction type A MCQs (2024) · cites this paper as [56]

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Research works printed but not linked: 1

  1. Norman G. Evaluation methods: A resource handbook. In: Shannon S, Norman, G, editors. Chapter 4.1. Multiple choice question. The Program for Educational Development, McMaster University. Hamilton, Canada: McMaster University, 1995:47-54.

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Authors
Sim, S.-M., & Rasiah, R. I.
Affiliations
University of Malaya (MY)
ORCID
Sim, Si-Mui
Venue
Annals of the Academy of Medicine, Singapore
Publisher
Academy of Medicine, Singapore
Published
2006-01-15
Volume
35
Issue
2
Pages
67-71
ISSN
0304-4602 (ISSN-L)
DOI
10.47102/annals-acadmedsg.v35n2p67
OpenAlex
W2141521353
Cited by
196
References
10
Citations by year
2026: 6 · 2025: 12 · 2024: 10 · 2023: 10 · 2022: 14 · 2021: 25 · 2020: 19 · 2019: 12 · 2018: 13 · 2017: 18 · 2016: 12 · 2015: 10 · 2014: 8 · 2013: 5 · 2012: 5
FWCI
1.67
Type
journal article
Language
en
Open access
Locations
  • Annals of the Academy of Medicine Singapore (publishedVersion)
  • PubMed (publishedVersion)
  • The University of Malaya Research Repository (University of Malaya) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Social Sciences › Education › Educational Assessment and Pedagogy
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords
item difficulty, item discrimination, item analysis, negative discrimination, undergraduate medical education
MeSH terms
Adult, Choice Behavior, Education, Medical, Undergraduate, Educational Measurement, Humans

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