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Relationship Between Item Difficulty and Discrimination Indices in True/False-Type Multiple Choice Questions of a Para-clinical Multidisciplinary Paper
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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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From AI in medical education: uses of AI in construction type A MCQs (2024) · cites this paper as [56]
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Metadata
- 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)
- 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
- green
- eprints.um.edu.my
- Locations
- Annals of the Academy of Medicine Singapore (publishedVersion)
- PubMed (publishedVersion)
- The University of Malaya Research Repository (University of Malaya) (submittedVersion)
- Topics
- Social Sciences › Education › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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