Use of flawed multiple-choice items by the New England Journal of Medicine for continuing medical education

Abstract

Physicians in the United States are required to complete a minimum number of continuing medical education (CME) credits annually. The goal of CME is to ensure that physicians maintain their knowledge and skills throughout their medical career. The New England Journal of Medicine (NEJM) provides its readers with the opportunity to obtain weekly CME credits. Deviation from established item-writing principles may result in a decrease in validity evidence for tests. This study evaluated the quality of 40 NEJM MCQs using the standard evidence-based principles of effective item writing. Each multiple-choice item reviewed had at least three item flaws, with a mean of 5.1 and a range of 3 to 7. The results of this study demonstrate that the NEJM uses flawed MCQs in its weekly CME program.

Notes

Notes

This study was first presented at the annual meeting of the Association of American Medical Colleges, Boston, MA, 2004.

Additional information

Notes on contributors

Alex S. Stagnaro-Green

ALEX STAGNARO-GREEN, MD MHPE, is Associate Dean for Curriculum and Faculty Development at New Jersey Medical School and Professor of Medicine and Professor of Obstetrics, Gynecology, & Women's Health. Dr Stagnaro-Green has been the architect of major curricular reform at two medical schools, is an LCME site visitor, and is published in a number of areas related to medical education.

Steven M. Downing

STEVEN M. DOWNING, PhD is an Associate Professor at the University of Illinois at Chicago in the Department of Medical Education (UIC-DME) specializing in assessment. Dr Downing teaches assessment courses in the Masters of Health Professions Education program (MHPE) at DME, carries out research in educational measurement, and consults with national and international assessment groups.