Test Taking Tips for Students Morton Diamond F.A. Davis Company

5 Tips for Writing Better Multiple-Choice Questions

How often do you make your own multiple-choice quizzes and tests? Probably quite a bit.

Here are five tips to keep in mind to help you create more pedagogically effective multiple-choice test items.

Let’s take a look first at terms pertinent to multiple-choice test items.

  • Stem—main text of the item; sets up the scenario to be solved
  • Options—choices provided after the stem from which the test taker must choose
  • Answer—correct option
  • Distracter—incorrect options


Keep the following tips in mind when writing test items.

1. Use a “Which of the following” construct. For instance, “Which of the following symptoms generally appears first in a patient with appendicitis?” Keep this construct consistent, and you’re on your way.
2. Use complete stems. Remember that the good student should be able to answer the question directly from the stem without ever seeing the responses.
3. Write clear stems. When using a “which of the following” approach, make sure to insert a category that relates to the responses. For instance, rather than writing “Which of the following generally appear first?” write “Which of the following symptoms appear first?”
4. Make sure each stem is a complete sentence in question form and without a blank. So rather than, “The first symptom to appear is_________,” write “Which of the following is the first symptom to appear?”
5. Write purposeful options. Don’t just write a bunch of options and then letter them. Use a specific structure for that particular question. For instance, when all responses consist of numerals, list them numerically in either increasing or decreasing order. Don’t mix them up.

If one response is short, one is long, and the others are in-between, list them according to overall length, from shorter to longer or vice versa.

If each response consists of just one or two words, list them alphabetically.

Focusing on the structure of the responses instead of using a let’s-see, which-letter-haven’t-I-used-lately-for-the-correct-response kind of approach helps keeps the test taker honest. The savvy test taker but poor student won’t be able to figure out the correct response from the structure alone.


*This post originally appeared on Andy McPhee’s blog on writing, editing, and publishing in health care education.

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