Assessment of item-writing flaws in multiple-choice questions.

This study evaluated the quality of multiple-choice questions used in a hospital's e-learning system. Constructing well-written questions is fraught with difficulty, and item-writing flaws are common. Study results revealed that most items contained flaws and were written at the knowledge/comprehension level. Few items had linked objectives, and no association was found between the presence of objectives and flaws. Recommendations include education for writing test questions.