IMPRECISE TERMS IN UK MEDICAL MULTIPLE-CHOICE QUESTIONS - WHAT EXAMINERS THINK THEY MEAN

Many multiple-choice questions (MCQs) used in medical education in the UK contain undefined, imprecise terms. They are particularly common i n true/false items and can be found in classroom tests, published exam ples of MCQs and, more importantly, in high-stakes examinations which determine a candidate's graduation or membership of a professional bod y. This study investigated imprecise terms used in some MB BS finals e xaminations and the Part 1 Membership Examination of the Royal College of Physicians. It revealed that imprecise terms occur commonly, yet t here is a wide range of opinion among the examiners themselves about t heir meanings. The numbers and variety of imprecise terms which were f ound in high-stakes MCQ examinations are described in this paper and d etails are given concerning the lack of consensus about their meanings as reported by the responsible examiners. A second type of constructi on error - disproportionately large numbers of 'true' branches - was a lso recorded. Exemplary practices do exist in MCQ quality assurance, b ut in the UK they are very much the exception rather than the rule. Th e findings of this investigation strongly indicate a need for change.