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An investigation into the optimal number of distractors in single-best answer exams

机译：单次最佳答案考试中最佳干扰因素的调查

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In UK medical schools, five-option single-best answer (SBA) questions are the most widely accepted format of summative knowledge assessment. However, writing SBA questions with four effective incorrect options is difficult and time consuming, and consequently, many SBAs contain a high frequency of implausible distractors. Previous research has suggested that fewer than five-options could hence be used for assessment, without deterioration in quality. Despite an existing body of empirical research in this area however, evidence from undergraduate medical education is sparse. The study investigated the frequency of non-functioning distractors in a sample of 480 summative SBA questions at Cardiff University. Distractor functionality was analysed, and then various question models were tested to investigate the impact of reducing the number of distractors per question on examination difficulty, reliability, discrimination and pass rates. A survey questionnaire was additionally administered to 108 students (33 % response rate) to gain insight into their perceptions of these models. The simulation of various exam models revealed that, for four and three-option SBA models, pass rates, reliability, and mean item discrimination remained relatively constant. The average percentage mark however consistently increased by 1-3 % with the four and three-option models, respectively. The questionnaire survey revealed that the student body had mixed views towards the proposed format change. This study is one of the first to comprehensively investigate distractor performance in SBA examinations in undergraduate medical education. It provides evidence to suggest that using three-option SBA questions would maximise efficiency whilst maintaining, or possibly improving, psychometric quality, through allowing a greater number of questions per exam paper.
机译：在英国医学院中，五选项单一最佳答案（SBA）问题是总结性知识评估的最广泛接受的格式。但是，用四个有效的不正确选项编写SBA问题既困难又耗时，因此，许多SBA包含大量令人难以置信的干扰因素。先前的研究表明，可以使用少于五种选择进行评估，而不会降低质量。尽管在该领域已有大量的实证研究，但是来自大学医学教育的证据仍然很少。这项研究调查了卡迪夫大学（Cardiff University）的480个SBA总结性问题样本中无功能的干扰物的频率。分析干扰因素的功能，然后测试各种问题模型，以研究减少每个问题干扰因素的数量对考试难度，可靠性，辨别力和通过率的影响。此外，还对108名学生（33％的回应率）进行了调查问卷，以了解他们对这些模型的看法。对各种考试模型的仿真显示，对于四选项和三选项SBA模型，通过率，可靠性和平均项目区分度保持相对恒定。但是，四选项和三选项模型的平均百分比分别持续增加1-3％。问卷调查显示，学生团体对拟议的格式更改持不同意见。这项研究是第一个全面调查本科医学教育中SBA考试中干扰因素表现的研究之一。它提供了证据表明使用三选项SBA问题可以通过在每张试卷中允许更多的问题来最大化效率，同时保持或可能改善心理测量的质量。

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