• Sarmud Latif Awan AJK Medical College, Muzaffarabad
  • Shagufta Manzoor Department of Anatomy, AJK Medical College, Muzaffarabad, Pakistan
  • Irum Gillani Department of Community Medicine, AJK Medical College, Muzaffarabad, Pakistan
  • Ziyad Afzal Kayani Department of Surgery, AJK Medical College, Muzaffarabad, Pakistan
  • Humza Farooq Department of Surgery, Shifa International Hospital, Islamabad, Pakistan
  • Sahar Khurshid Department of Surgery, Abbas Institute of Medical Sciences, Muzaffarabad, Pakistan




MCQs, flawed items, Academic achievements, Medical Education, Undergraduate


Background: The most popular written exam in health professions education is the multiple-choice style question (MCQ). This study sought to understand the effects of multiple-choice writing errors on students' academic performance in medical education. Methods: This descriptive study was done from December 2017 to June 2019 in Azad Jammu Kashmir (AJK) Medical College, Muzaffarabad. Ten block examinations were included. The item review committee reviewed all MCQs for flaws. Two tests from each class of MBBS were taken. The original tests containing all items were labeled as flawed tests and the result of each flawed test was evaluated. The students were graded into high, moderate and low achievement groups with scores of more than 79.9, between 50–79.9 and less than 50 percent respectively. Flawed items were then removed from the tests by the review committee and the scores of each test (standard test) were determined and compared with flawed tests and its effects were assessed in three achieving groups of students. Optical mark reading (OMR) classic-4 software was used for post-exam analysis and data were analyzed by using SPSS-25.  Results: The passing rate ranged from 68.18% to 90.82% in flawed and 75.54% to 93.69% in standard tests. Most standard tests (7) had higher passing rates than flawed tests. Conclusion: Tests containing in-house developed MCQs have frequent item writing flaws and their inclusion in assessment did affect the passing rates of students but were not statistically significant.

Pak J Physiol 2023;19(4):49–52


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How to Cite

Awan SL, Manzoor S, Gillani I, Kayani ZA, Farooq H, Khurshid S. TYPES OF ITEM WRITING FLAWS IN MULTIPLE CHOICE QUESTIONS IN MEDICAL EDUCATION AND THEIR EFFECT ON PASSING RATE OF STUDENTS. Pak J Phsyiol [Internet]. 2023 Dec. 31 [cited 2024 Jul. 23];19(4):49-52. Available from: https://pjp.pps.org.pk/index.php/PJP/article/view/1587