Nurse Education Today
Volume 30, Issue 6 , Pages 539-543 , August 2010

A comparison of the psychometric properties of three- and four-option multiple-choice questions in nursing assessments

  • Marie Tarrant

      Affiliations

    • Department of Nursing Studies, 4/F, William M.W. Mong Block, Li Ka Shing Faculty of Medicine, 21 Sassoon Road, Hong Kong
    • Corresponding Author InformationCorresponding author. Tel.: +852 2819 2643; fax: +852 2872 6079.
    • ,
  • James Ware

      Affiliations

    • Director of Medical Education, Centre of Medical Education, Faculty of Medicine, Health Sciences Centre, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait

,Accepted 7 November 2009.

References 

  1. Aamodt MG, McShane T. A meta-analytic investigation of the effect of various test item characteristics on test scores. Public Personnel Management. 1992;21(2):151–160
  2. Beuchert AK, Mendoza JL. A Monte Carlo comparison of ten item discrimination indices. Journal of Educational Measurement. 1979;16(2):109–118
  3. Broome ME. The faculty shortage in nursing: global implications. Nursing Outlook. 2009;57(1):1–2
  4. Case SM, Swanson DB. Constructing Written Test Questions for the Basic and Clinical Sciences. Philadelphia, PA: National Board of Medical Examiners; 2003;
  5. Cizek GJ, O’Day DM. Further investigations of nonfunctioning options in multiple-choice test items. Educational and Psychological Measurement. 1994;54(4):861–872
  6. Crehan KD, Haladyna TM, Brewer BW. Use of an inclusive option and the optimal number of options for multiple-choice items. Educational and Psychological Measurement. 1993;53(1):241–247
  7. Downing SM. Threats to the validity of locally developed multiple-choice tests in medical education: construct-irrelevant variance and construct underrepresentation. Advances in Health Sciences Education. 2002;7(3):235–241
  8. Ebel RL, Frisbie DA. Essentials of Educational Measurement. Englewood Cliffs, NJ: Prentice Hall; 1991;
  9. Gronlund NE, Waugh CK. Assessment of Student Achievement. Upper Saddle River, N.J: Pearson; 2008;
  10. Haladyna TM. Developing and Validating Multiple-Choice Test Items. Mahwah, NJ: Lawrence Erlbaum; 2004;
  11. Haladyna TM, Downing SM. How many options is enough for a multiple-choice test item?. Educational and Psychological Measurement. 1993;53(4):999–1010
  12. Haladyna TM, Downing SM, Rodriguez MC. A review of multiple-choice item-writing guidelines for classroom assessment. Applied Measurement in Education. 2002;15(3):309–334
  13. Masters JC, Hulsmeyer BS, Pike ME, Leichty K, Miller MT, Verst AL. Assessment of multiple-choice questions in selected test banks accompanying text books used in nursing education. Journal of Nursing Education. 2001;40(1):25–32
  14. McCoubrie P. Improving the fairness of multiple-choice questions: a literature review. Medical Teacher. 2004;26(8):709–712
  15. Oosterhof AC. Similarity of various item discrimination indices. Journal of Educational Measurement. 1976;13(2):145–150
  16. Osterlind SJ. Constructing Test Items: Multiple-Choice, Constructed-Response, Performance, and Other Formats. Boston: Kluwer Academic Publishers; 1998;
  17. Owen SV, Froman RD. What’s wrong with three-option multiple choice items?. Educational and Psychological Measurement. 1987;47(2):513–522
  18. Pamplett R, Farnhill D. Effect of anxiety on performance in multiple-choice examinations. Medical Education. 1995;29:298–302
  19. Precht D, Hazlett C, Yip S, Nicholls J. International Database for Enhanced Assessments and Learning (IDEAL-HK): Item Analysis Users’ Guide. Hong Kong: IDEAL-HK; 2003;
  20. Rodriguez MC. Three options are optimal for multiple-choice items: a meta-analysis of 80 years of research. Educational Measurement: Issues and Practice. 2005;24(2):3–13
  21. Rogers WT, Harley D. An empirical comparison of three- and four-choice items and tests: susceptibility to test wiseness and internal consistency reliability. Educational and Psychological Measurement. 1999;59(2):234–247
  22. Schuwirth LWT, van der Vleuten CPM. ABC of learning and teaching in medicine: Written assessment. BMJ. 2003;326(7390):643–645
  23. Schuwirth LWT, van der Vleuten CPM. Different written assessment methods: what can be said about their strengths and weaknesses?. Medical Education. 2004;38(9):974–979
  24. Sidick JT, Barrett GV, Doverspike D. Three-alternative multiple choice tests: an attractive option. Personnel Psychology. 1994;47(4):829–835
  25. StataCorp, 2005. Stata Statistical Software: Release 9.2. StataCorp LP, College Station, TX.
  26. Tarrant M, Knierim A, Hayes SK, Ware J. The frequency of item writing flaws in multiple-choice questions used in high stakes nursing assessments. Nurse Education Today. 2006;26(8):662–671
  27. Tarrant M, Ware J. Impact of item-writing flaws in multiple-choice questions on student achievement in high-stakes nursing assessments. Medical Education. 2008;42(2):198–206
  28. Tarrant, M., Ware, J., Mohammed, A.M., 2009. An assessment of functioning and non-functioning distractors in multiple-choice questions: a descriptive analysis. BMC Medical Education 9, 40.
  29. Trevisan MS, Sax G, Michael WB. The effects of the number of options per item and student ability on test validity and reliability. Educational and Psychological Measurement. 1991;51(4):829–837

PII: S0260-6917(09)00214-7

doi: 10.1016/j.nedt.2009.11.002

Nurse Education Today
Volume 30, Issue 6 , Pages 539-543 , August 2010

Article Tools

* Image Usage & Resolution