Best Practices Related to Examination Item Construction and Post-hoc Review.

Objective. To provide a practical guide to examination item writing, item statistics, and score adjustment for use by pharmacy and other health professions educators. Findings. Each examination item type possesses advantages and disadvantages. Whereas selected response items allow for efficient assessment of student recall and understanding of content, constructed response items appear better suited for assessment of higher levels of Bloom's taxonomy. Although clear criteria have not been established, accepted ranges for item statistics and examination reliability have been identified. Existing literature provides guidance on when instructors should consider revising or removing items from future examinations based on item statistics and review, but limited information is available on performing score adjustments. Summary. Instructors should select item types that align with the intended learning objectives to be measured on the examination. Ideally, an examination will consist of multiple item types to capitalize on the advantages and limit the effects of any disadvantages associated with a specific item format. Score adjustments should be performed judiciously and by considering all available item information. Colleges and schools should consider developing item writing and score adjustment guidelines to promote consistency.