Medical Education Technologies are looking for question writers

Become a question writer today! This is a great opportunity to demonstrate teaching skills and boost your CV and portfolio

Eligibility

  1. Medical student or Medical graduate
  2. Completed pre-clinical studies

Essential

  1. Create content – in line with provided guidelines
  2. Edit content – in line with feedback provided by Medical Education Technologies Ltd

All question writers who meet provided guidelines will be awarded with a certificate of completion.

With author permission, names will be listed on the “About Us” section of our website (currently under development)

Name only 1Q= Contributor

Photo and name 10Q = Senior contributor

Photo, name and short description 50Q = Question developer

How to take part

  1. Read our guidelines
  2. Submit via this link https://docs.google.com/forms/d/1i00P0F5PCgj17qcy31WZgkryCNTcdtLRGnF3ByaxWJI/edit
  3. We will get in touch with feedback and ask you to edit content if necessary
  4. Forms – we require you to sign a consent form if you wish for your name to be published on our site and an IP transfer form for your submission.

Any questions – please email us at info@ukmlaforums.com

 

 

Guidelines for good MCQ questions

Requirements

  • Exceptionally well written
  • Sound clinical reasoning
  • Clear explanation that tells you why the answer is right
  • Clear explanation that tells you why the other options are If appropriate some indication of how the question stem would change to make a wrong answer correct.

Rules for question stem

  1. Emphasise higher-level thinking –

Use memory –plus questions that require students to recall principles, rules or facts in context.

Demand that the students go through more than one step to get to the correct answer! Test comprehension and critical thinking not just recall.

The stem can be relatively long, the options should be short.

  1. Ensure question is context

Give context by adding a case scenario with observations/images/lab values etc. The stem should be 3 to 6 sentences in length

If using a scenario use this order à the presenting problem of a patient, followed by the history, physical findings, result of diagnostic studies, initial treatment

Bad example

Which description best characterizes whole foods?

  1. orange juice
  2. toast
  3. bran cereal
  4. grapefruit

 

  1. Test high-yield relevant content

Focus on common clinical problems . Don’t test niche facts or very rare complications. Stick to what all doctors should know.

Rules for distractors

  1. Use plausible distractors (wrong responses) – use distractors that test the students’ knowledge. All the wrong options should be completely reasonable/ logically compatible! This can be very hard to achieve – if you need help put n/a into the googleforms and when we will get back to you with advise!
    Don’t just choose giveaway wrong answers
  2. Use homogenous distractors
    They should fall into the same category as the correct answer (e.g., all diagnoses, test, treatments, medications, dosages).
    Avoid using “double options” (e.g., do W and X; do Y because of Z) unless the correct answer and all the distracters are double options.
  3. Keep option lengths similar – don’t make the correct answer the long or short answer
  4. Don’t use negative distractorsg. Doesn’t need a CT scan USE CT scan needed instead (as a wrong option)
  5. Avoid using “none of the above”, “all of the above”
  6. Avoid extremesg. always and never in options
  7. Avoid vague termsg. rarely , usually

 

Rules for explanation of the correct answer

  1. Use diagrams/ tables and images
  2. Be concise but make sure explanation is thorough

Rules for explanation of the incorrect answer

  1. Explain under what circumstances the incorrect answer would be correct
  2. Explain any changes to the question stem that would make the answer correct

General rules

  • Ensure accurate spelling and punctuation
  • Make sure it is a question you would want to see in your exam
  • Make sure the explanation helps the reader learn!
  • Avoid double negatives

Please see the following page for some examples of stems, lead-ins and options list

 

EXAMPLE STEMS

  1. 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)?
  2. A (patient description) is currently on (specific medication). Which of the following conditions is most likely to occur?
  3. A (patient description) has (symptoms, signs, or specific disease) and is being treated with (drug or drug class). The drug acts by inhibiting which of the following (functions, processes)?
  4. A (patient description) has (abnormal findings). What would the most appropriate (drug therapy)?
  5. A (patient or group description) became ill with (symptoms and signs). Which of the following (organisms, agents) is most likely to be the cause? 6.
  6. A (patient description) has (symptoms and signs). Exposure to which of the (toxic agents/ risk factor/ family history) is the most likely cause?

 

SAMPLE LEAD-INS AND OPTION LISTS

  1. Which of the following is (abnormal)? Options sets could include sites of lesions; list of nerves; list of muscles; list of enzymes; list of hormones; types of cells; list of neurotransmitters; list of toxins, molecules, vessels, spinal segments.
  2. Which of the following findings is most likely? Options sets could include list of laboratory results; list of additional physical signs; results of microscopic examination of fluids, serum levels.
  3. Which of the following is the most likely cause? Options sets could include list of underlying mechanisms of the disease; medications that might cause side effects; drugs or drug classes; toxic agent or family history or other risk factors etc.
  4. .Which of the following should be administered? Options sets could include drugs, vitamins, amino acids, enzymes, hormones.
  5. Administration of {specific drug/ intervention } is most likely to have which of the following effects? Options: (List of physiological effects)

 

 

Good question

A 41-year-old woman with a long-standing history of well controlled type 1 diabetes presents to her GP complaining that, despite taking the same doses of insulin that she has for the last 10 years, she has recently developed new episodes of hypoglycaemia which she has managed herself. She also says that she has lost weight recently, despite her best efforts to eat more. On examination you notice that she has several ulcers in her mouth. What single further investigation is most appropriate in this setting to diagnose the likely disease?

A: IgA anti-tTG antibodies

B: White cell count

C: Faecal calprotectin

D: Endoscopy followed by jejunal biopsy

E: IgA anti-EMA antibodies

 

The answer is A. New onset hypoglycaemia in a type 1 diabetic usually indicates either Addison’s disease, coeliac disease or more rarely hypothyroidism due to the underlying autoimmune link between the conditions.

The question is asking what blood test is most useful for the GP to perform. First line investigation into coeliac disease is via IgA anti-tissue transglutaminase antibodies, as well as measuring overall IgA levels to prevent a false negative (i.e. if the patient has coeliac disease but has general IgA deficiency, then no anti-tTg antibodies will be seen despite having coeliac disease). Anti tTg, and other investigations, will only be positive if the patient has eaten gluten in the last 6 weeks.

Other options

B: White cell count – Coeliac disease is associated with leukopenia but this is not useful in diagnosis. This investigation would be appropriate if infection is suspected. However, infections are prone to cause hyperglycaemia as opposed to hypoglycaemia, meaning insulin doses may have to be increased during times of infection.

C: Fecal calprotectin is used in IBD diagnosis, not coeliac disease. Chron’s is a differential in this case due to the mouth ulcers and weight loss, but is not as likely as coeliac disease due to the autoimmune link between T1DM and coeliac disease. Chron’s is not characteristically associated with new onset hypoglycaemia.

D: Biopsy is useful to confirm the diagnosis, but this is not a first line investigation.

E: Anti-endomysial antibodies are useful in diagnosing coeliac disease, but are only tested for if IgA tTG is weakly positive. If first line IgA tTG is unambiguously positive, the patient is referred to a gastrointestinal specialist for endoscopy and jejunal biopsy (NICE guidelines).

 

Bad question

You are an SHO on gynaecology ward and are asked to speak to Mrs. Smith, a 42-year-old patient who yesterday had a subtotal hysterectomy for fibroids. No other procedure has been performed. She would like to know if she needs:

  1. hormone replacement therapy
  2. smear testing

 

  1. yes and yes
  2. yes and no
  3. no and no
  4. no and yes

 

Answer: c

Rationale: this question is designed to test students’ knowledge of surgical terminology. Subtotal hysterectomy implies removal of uterus with the sparring of the cervix, so Mrs. Smith will still need to get regularly tested for cervical cancer.

There is no mention of bilateral salpingo-oophorectomy (BSO), which suggests that her ovaries were left behind and hence she doesn’t need HRT.