Transcript MCQ - หน้าแรก

MCQ
Multiple Choice Questions
Why concern?
• ยังคงมีการใช้ อยู่
–ข้ อสอบ comprehensive 4 สถาบัน
–ข้ อสอบ national test แพทยสภา
• เชียงใหม่ (ดูเหมือนจะ) มีปัญหา
–ภาควิชาส่ วนใหญ่ ไม่ มีระบบคัดกรองข้ อสอบอย่ างจริ งจัง
–สั ดส่ วนข้ อสอบได้ รับการคัดเลือกน้ อย
–ผลการสอบของ นศพ. เชียงใหม่ ไม่ สวยงามเท่ าไรนัก
Why still be used?
• reliability

• content validity 
• practicality

Why educator hate it?
• poor MCQ
–validity

• patient doesn’t come with choices!
–lower order thinking
• recall
First Conclusion
• It still be used
• National licensing examination
–Part I: basic sc
–Part II: clinical sc
300 items
450 items
• We have to improve ourselves
How to construct?
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planning
writing
reviewing and revising
publishing
How to improve?
• knowledge
• skill
• attitude
Basic Knowledge
• Theoretically; MCQ =
–one best answer, +
–matching, +
–extended matching, + etc
• Practically;
–MCQ => one best answer
Planning
• identify the outcome
–Medical Council Standard
–cognitive domain
Cognitive Domain
evaluation
problem-solving
synthesis
analysis
interpretation
Application
application
comprehensive
recall
knowledge
recall
Planning
• identify the outcome
–Medical Council Standard
–cognitive domain
• identify number of item
–time => 150 item : 180 min
–formula
• table of specification
Table of Specification
น ้าหนัก
(รวม 100%)
จานวนข้ อสอบ
(รวม 300 ข้ อ)
B1 General Principles
33%
100
B1.1
Biochemistry and molecular biology
10%
10
B1.2
Biology of cells
10%
10
B1.3
Human development and genetics
10%
10
B1.4
Biology of tissue response to disease
10%
10
B1.5
Gender, ethnic, and behavioral
considerations affecting disease
treatment and prevention, including
psychosocial, cultural, occupational,
and environment
5%
5
สาระ
Table of Specification
น ้าหนัก
(รวม 100%)
จานวนข้ อสอบ
(รวม 300 ข้ อ)
B1 General Principles
33%
100
B1.6
Multisystem processes
10%
10
B1.7
Principles of specimen collections and
laboratory interpretations
5%
5
B1.8
Pharmacodynamic and pharmacokinetic
processes
10%
10
B1.9
Microbial biology and infection
10%
10
B1.10
Immune responses
10%
10
B1.11
Quantitative methods
10%
10
สาระ
Table of Specification
น ้าหนัก
(รวม 100%)
จานวนข้ อสอบ
(รวม 300 ข้ อ)
B2 Hematopoietic and Lymphoreticular System
7.4%
22
B2.1
Normal processes
40%
9
B2.2
Abnormal processes
40%
9
B2.3
Principles of therapeutics
10%
2
B2.4
Gender, ethnic, and behavioral
considerations affecting disease
treatment and prevention, including
psychosocial, cultural, occupational, and
environment
10%
2
สาระ
Table of Specification
• Cognitive taxonomy ratio
–recall : application
• basic sciences = 50:50
• body system = 30:70
Planning
• identify the outcome
–Medical Council Standard
–cognitive domain
• identify number of item
–time => 150 item : 180 min
–formula
• table of specification
Writing
• 1 item = stem + options
• stem
• options / choices
–1 answer / key
–3-4 distracters
• avoid testwiseness
• avoid irrelevant difficulty
Good Stem
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Valid
What? => TMC standard
Which aspect? => Form
How deep? => For GP
Good Stem
• avoid
–trivial fact
• color reagent
• enzyme
–extreme recall
• the second most common
• the least common
Good Stem
• 1 stem = 1 aspect
• No more
–What are … and …?
• Usually long stem + short
options
• Don’t teach in the test!
Good Stem
• 1 stem = 1 aspect
• No more
–What are … and …?
• Usually long stem + short
options
• Don’t teach in the test!
Good Stem
• Vignette + leading question
Item template : Gross anatomy
A (patient description) is unable to (functional
disability). Which of the following is most likely to
have been injured?
A 65-year-old man has difficulty rising from a
seated position and straightening his trunk, but he
has no difficulty flexing his leg. Which of the
following muscles is most likely to have been
injured?
Good Stem
Item template :
A (patient description) has (history findings)
and is taking (medications). Which of the
following medications is the most likely cause
of his (one history, PE or lab finding)?
Item template :
A (patient description) has a (type of injury
and location). Which of the following
structures is most likely to be affected?
Good Stem
Item template :
A (patient description) has (abnormal
findings). Which [additional] finding would
suggest/suggests a diagnosis of (disease 1)
rather than (disease 2)?
Item template :
A (patient description) dies of (disease). Which
of the following is most likely finding on
autopsy?
Good Stem
A patient has (abnormal findings) but
(normal findings). Which of the following
is the most likely diagnosis?
Item template :
A patient has (symptoms and signs).
Which of the following is the most likely
explanation for the (findings)?
Good Stem
• Series of stems are fine
–BUT independent
Good Stem
• Should not
–What do you think?
Good Stem
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allow data gathering
provide a sizable data base
simulate reality
include appropriate “noise”
start with problem, not a diagnosis
use unfamiliar (not uncommon) case
test only cognitive objective
avoid diagnostic label
Good Options
• same direction
• similar length, otherwise
–long answer + short distracters
• similar style, otherwise
–nice answer (copy from textbook) +
poor distracters
Good Distractors
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incorrect!
reasonable
common misunderstanding
common mistakes
Options Tidiness
• sequencing
–alphabetical
–length
–chronological
–logical
• word repeated
Testwiseness
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grammatically guide
totally, absolutely, none, etc
latin translation
all of above, none of above, K
type
• question A => answer of
question B
Unawares, the answer
• is usually the option which is
–longest
–looked nicest
–most understandable
–appeared most frequent
Irrelevant difficulty
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poor written, poor chart
double negative
too long, too complicated
difficult vocabulary, jargon
unordered number
subjective : often, usually
tricky
How to construct?
• planning
• writing
• reviewing and revising
–self-test
–pilot / colleagues
• publishing
–readable
How to improve?
• Knowledge
• Skill
• Attitude
Skill
• Practicing
–Form
–Item development team
–Item analysis
Miscellaneous
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AI
p
r
item sequencing
Conclusion
• Knowledge
• Skill
• Attitude