[Medical journals as implicit role models for good multiple choice questions: to which degree have CME tests so far fulfilled formal quality criteria?].

BACKGROUND

Many clinicians, particularly those from university hospitals and associated teaching hospitals, use multiple-choice questions in different professional roles: as examiners for student assessment and as life-long learners in respect to the CME programmes of medical journals. For this group of physicians it might thus be desirable that medical journals serve as implicit role models for formulating high-quality multiple-choice questions.

METHOD

370 multiple-choice questions taken from the 2011 volumes of three different medical journals were reviewed. A checklist consisting of 11 formal quality criteria, 5 quality categories and one global criterion, taken from the literature and from the German Item Management System, was used.

RESULTS

High-quality questions were found in the categories "language", "structure", and "signposting the question type." However, "application to cases or problems" and "analysis, interpretation, problem solving" were realised in less than 20 %, and "cues" were detected in almost half of the questions. A subgroup analysis showed different quality levels between the journals.

CONCLUSIONS

To serve as role models for high-quality multiple-choice questions (MCQ) German medical journals should deliver formal quality criteria and good writing examples to their MCQ authors and ensure strict adherence to these criteria. The development of journal-independent formal standards might prove worthwhile.