What steps are necessary to create written or web-based selected-response assessments?

Before we work out what constitutes an assessment's value for a given cost in medical education, we must first outline the steps necessary to create an assessment, and then assign a cost to each step. In this study we undertook the first phase of this process: we sought to work out all the steps necessary to create written selected-response assessments. First, the lead author created an initial list of potential steps for developing written assessments. This was then distributed to the other three authors. These authors independently added further steps to the list. The lead author incorporated the contributions of these others and created a second draft. This process was repeated until consensus was achieved amongst the study's authors. Next, the list was shared by means of an online questionnaire with 100 healthcare professionals with experience in medical education. The results of the authors' and healthcare professionals' thoughts and feedback on the steps, needed to create written assessment, are outlined below in full. We outlined the steps that are necessary to create written or web-based selected-response assessments.