The proposition that the optimal number of options in a multiple choice test item is three was examined. The concept of functional distractor, a plausible wrong answer that is negatively discriminating when total test performance is the criterion, is discussed. Three distinct groups of achievers (high, middle, and low) on a national standardized…

In this paper 45 item-writing rules for multiple-choice tests presented in textbooks on educational measurement in a previous study are identified. The current study presents a quantitative review of the literature with respect to the empirical and theoretical evaluation of these principles of item-writing. Fifty-six studies that addressed at…

To test the effect of clinically relevant multiple-choice item content on the validity of statistical discriminations of physicians' clinical competence, data were collected from a field test of the Emergency Medicine Examination, test items for the certification of specialists in emergency medicine. Two 91-item multiple-choice subscales were…