Multiple choice questions

Multiple choice questions (MCQs) can be an excellent tool for self-guided learning, allowing individuals to identify areas where their knowledge is weak, as well as allowing the development of metrics to compare oneself with one's peers. They are also extensively used in assessment during medical training.

For questions to be useful, however, they need to be well-written and adhere to a number of best practices.

For novice question setters, be aware that writing high-quality MCQs is probably more difficult than you would think, and like most things in life, practice helps!

The rest of this article and linked articles on specific topics cover a number of aspects of authoring multiple choice questions as it relates to Radiopaedia.org, including terminology, types of questions, and best practices. 

Better still, we have created a learning pathway to get you started. All questions must be in line with our style guide and therefore it is mandatory that you go through the MCQ learning pathway before authoring your first questions. It doesn't take long. 

Begin the creating MCQ Learning Pathway

Who can create questions?

Multiple choice questions can be created by any registered user and questions undergo the usual moderation. To create a new question go to the MCQs tab of your profile and click "Create new question". 

Originality

It is essential, as is the case for all content on Radiopaedia, that submitted multiple choice questions are both original and of high quality. Specifically, please do not copy questions from textbooks or other websites, nor submit 'recalled' questions from exams you have sat. We take copyright violations and plagiarism very seriously. 

Terminology 

A multiple choice question has a number of parts: 

1. stem and lead-in

   • the stem is the first part of the question, and typically contains the most words

   • the lead-in follows the stem, and leads into the alternatives, making it obvious what is being asked of the examinee in the question

   • short questions combine the two

   • read more: stems and lead-in
      

2. ​image

   • ​adding images is optional for basic factual and knowledge integration questions but mandatory for image interpretation questions

   • images can be chosen from existing cases or created specifically for multiple choice questions

   • read more: images for MCQs
     ​

3. alternatives (or options, choices): these are usually shorter and offer various options to choose from to answer or complete the stem

   • answer (or key): this is the alternative that is correct

   • distractor: these are alternatives (usually 3 to 5) that are incorrect

   • read more: alternatives
     ​

4. explanation

   • optional but ideally present for all questions

   • should explain both why the key (correct alternative) is correct and why the distractors are incorrect

   • should include image attribution if images are present

   • read more: explanation
      

5. related articles

   • each question should have a related article for each alternative

   • sometimes this means only one related article, sometimes six

   • read more: related articles

Types of questions

All multiple choice questions on Radiopaedia are of the "single best answer" type. In other words, each question has only one correct answer out of the 4 to 6 options. This is the most commonly encountered type of question and is believed to be the most effective by educators. 

Radiopaedia has three specific types of questions, each designed to achieve different educational goals. They are: 

1. basic factual

2. knowledge integration

3. image interpretation

Checklist

If embarking upon writing questions, please be familiar with this section of the style guide and work your way through this checklist until it is second nature to you. 

External links

• Writing Effective Multiple Choice Items by Petra J. Lewis, MD (YouTube)

If any of these links are broken or for other problems and questions, please contact [email protected].