Department of Nursing Studies, 4/F, William M.W. Mong Block, Li Ka Shing Faculty of Medicine, 21 Sassoon Road, Hong Kong.
Nurse Educ Today. 2010 Aug;30(6):539-43. doi: 10.1016/j.nedt.2009.11.002. Epub 2010 Jan 6.
In multiple-choice tests, four-option items are the standard in nursing education. There are few evidence-based reasons, however, for MCQs to have four or more options as studies have shown that three-option items perform equally as well and the additional options most often do not improve test reliability and validity. The aim of this study was to examine and compare the psychometric properties of four-option items with the same items rewritten as three-option items. Using item-analysis data to eliminate the distractor with the lowest response rate, we compared three- and four-option versions of 41 multiple-choice items administered to two student cohorts over two subsequent academic years. Removing the non-functioning distractor resulted in minimal changes in item difficulty and discrimination. Three-option items contained more functioning distractors despite having fewer distractors overall. Existing distractors became more discriminating when infrequently selected distractors were removed from items. Overall, three-option items perform equally as well as four-option items. Since three-option items require less time to develop and administer and additional options provide no psychometric advantage, teachers are encouraged to adopt three-option items as the standard on multiple-choice tests.
在多项选择题测试中，四选一的选项是护理教育的标准。然而，很少有循证医学的理由支持多选题有四个或更多选项，因为研究表明，三选一的选项同样有效，而且额外的选项通常不会提高测试的可靠性和有效性。本研究旨在检查和比较四选一项目与重写为三选一项目的相同项目的心理测量学特性。使用项目分析数据消除反应率最低的干扰项，我们比较了两个随后的学年中两个学生群体进行的 41 个多项选择题的三选一和四选一版本。消除不起作用的干扰项后，项目的难度和区分度几乎没有变化。尽管三选一项目的干扰项总数较少，但其中包含更多的有效干扰项。当从项目中删除不常选择的干扰项时，现有的干扰项变得更具区分性。总的来说，三选一项目的表现与四选一项目一样好。由于三选一项目的开发和管理所需时间更少，而且额外的选项没有带来心理测量上的优势，因此鼓励教师采用三选一项目作为多选题测试的标准。
