[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-390351-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-390351-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","nbme-item-writing-guide-october-2024","NBME Item-Writing Guide - October 2024","","NBME Item-Writing Guide (October 2024) provides faculty-oriented guidance for constructing multiple-choice test questions for the health sciences. It outlines principles for item format and structure, common technical item flaws, and methods for analyzing item performance such as difficulty and discrimination. The guide explains how to write one-best-answer items for foundational and clinical knowledge, including selecting topics, determining cognition levels, and structuring clinical vignettes. It also covers using media in vignettes and offers appendices with quick-reference tools, sample lead-ins, retired item formats, and further resources.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/exam/","Exam",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/nbme-item-writing-guide-october-2024/390351/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/nbme-item-writing-guide-october-2024/390351.png","ImageObject",300,407,{"name":42,"@type":43},"Aria","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-10","2026-09-25",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",35,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the main purpose of the NBME Item-Writing Guide?","Question",{"text":63,"@type":64},"It helps health professions faculty improve the quality of multiple-choice items they write, and it explains item development and item analysis basics, including foundational concepts in psychometrics and measurement.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What core rules does the guide emphasize for one-best-answer items?",{"text":68,"@type":64},"Each item should focus on an important concept, assess application rather than isolated recall, use a lead-in that is focused and answerable from the vignette alone, and keep options homogeneous and plausible to avoid cueing.",{"name":70,"@type":61,"acceptedAnswer":71},"How does the guide address item quality issues and performance review?",{"text":72,"@type":64},"It identifies technical item flaws that add irrelevant difficulty or cue testwise examinees, and it covers item analysis using measures such as item difficulty, discrimination, and option behavior across test-taker groups.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},390351,1790624811,{"code":4,"msg":82,"data":83},"success",[84,88,92,95,100,105,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":93,"slug":94},70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":107,"show_sort_weight":108,"slug":109},7,"Healthcare",40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":96,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":33,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146,"preview_page_count":4},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","NBME ®  \nITEM-WRITING GUIDE  \nConstructing Written Test Questions for the Health Sciences  \nOCTOBER 2024  \nCONSTRUCTING WRITTEN TEST QUESTIONS FOR THE HEALTH SCIENCES  \nCONTRIBUTORS FROM NBME1  \nMelissa S. Billings Kristine DeRuchie Steven Go, MD  \nKieran Hussie Allison Kulesher Jacquelyn Merrell Amy Morales  \nMiguel A. Paniagua, MD Jennifer Sherlock  \nKimberly A. Swygert, PhD Julie Tyson  \nDirector, Test Development Technology  \nDirector, Test Materials Development  \nAssociate Vice President, Assessment Operations & Medical Education  \nManager, Multimedia Services and Applications Managing Editor  \nManaging Editor  \nDirector, Test Materials Development Medical Advisor  \nSenior Support Coordinator, Test Materials Development  \nDirector, Test Development Innovations  \nSenior Editor  \nPrinted copies are not mailed, supplied, distributed, or otherwise made available directly from National Board of Medical Examiners (NBME), except in conjunction with an NBME-sponsored activity (eg, item-writing workshop, meeting or seminar, promotional or otherwise) . Additional copies can be obtained by downloading the manual from the NBME website ([www. nbme.org](www. nbme.org)) . Permission to copy and distribute this document is granted by NBME provided that: (1) the copyright and permission notices appear on all reproductions; (2) use of the document is for noncommercial, educational, and scientific purposes only; and (3) the document is not modified in any way. Any rights not expressly granted herein are reserved by NBME.  \n1 Contributing authors for the previous editions of this book also included Susan M. Case, PhD, Steven Haist, MD, MS, and David B. Swanson, PhD.  \nCONTENTS  \n07 Section 1: Issues Related to Format and Structure of Test Items  \n\n| 09 | Chapter 1: Introduction |\n| --- | --- |\n|  | Assessment: An Important Component of Instruction |\n|  | Purposes of Testing |\n|  | What Material Should Be Tested? |\n| 11 | Chapter 2: Multiple-Choice Item Formats |\n| 17 | Chapter 3: Technical Item Flaws |\n|  | Flaws Related to Irrelevant Difficulty |\n|  | Flaws That Cue the Testwise Examinee |\n|  | Summary of Technical Item Flaws |\n| 26 | Chapter 4: Item Analysis and Interpretation of Results |\n|  | Analysis of Item Difficulty |\n|  | Analysis of Item Discrimination |\n|  | Analysis of Item Options |\n|  | Comparative Analyses of Test-taker Groups |\n| 31 | Section 2: Writing One-Best-Answer Items for the Foundational (Basic) and Clinical Sciences |\n| 33 | Chapter 5: Basic Rules for Writing One-Best-Answer Items |\n| Rule 1: Each item should focus on an important concept or testing point. |  |\n\nRule 2: Each item should assess application of knowledge, not recall of an isolated fact.  \nRule 3: The item lead-in should be focused, closed, and clear; the test-taker should be able to answer the item based on the vignette and lead-in alone.  \nRule 4: All options should be homogeneous and plausible to avoid cueing to the correct option.  \nRule 5: Each item should be reviewed to identify and remove technical flaws that add irrelevant difficulty or benefit savvy test-takers.  \nCONTENTS  \n36 Chapter 6: Testing Application of Foundational (Basic) and Clinical Knowledge  \n\n| Choosing the Topics to Test |  |\n| --- | --- |\n|  | Determining Level of Cognition to Assess |\n|  | Guidelines for Clinical Vignette Content |\n|  | The Patient Chart/Table Format |\n|  | The F-type Format |\n|  | Guideline(s) for Writing Item Lead-ins |\n|  | Structuring Items to Fit Task Competencies |\n| 56 | Chapter 7: Using Media as Part of Clinical Vignettes |\n|  | Types of Media |\n|  | Selecting Media |\n|  | Content Areas Conducive to the Use of Media |\n|  | Acquiring and Creating Media |\n|  | Tips for Creating Videos |\n|  | Media Accessibility |\n| 67 | Section 3: Appendices |\n| 69 | Appendix A: A Quick Reference Guide to Approaching Item Writing |\n| 70 | Appendix B: Sample Lead-ins Based on Task Competencies |\n| 85 | Appendix C: NBME Retired Item Formats |\n| 91 | Appendix D: Resources an","cbCaipNpFLimw4RX","https://ap.wps.com/l/cbCaipNpFLimw4RX","pdf",2733048,94,"English","# Section 1: Issues Related to Format and Structure of Test Items\n## Chapter 1: Introduction\n## Chapter 2: Multiple-Choice Item Formats\n## Chapter 3: Technical Item Flaws\n## Chapter 4: Item Analysis and Interpretation of Results\n# Section 2: Writing One-Best-Answer Items for the Foundational (Basic) and Clinical Sciences\n## Chapter 5: Basic Rules for Writing One-Best-Answer Items\n## Chapter 6: Testing Application of Foundational (Basic) and Clinical Knowledge\n## Chapter 7: Using Media as Part of Clinical Vignettes\n# Section 3: Appendices\n## Appendix A: A Quick Reference Guide to Approaching Item Writing\n## Appendix B: Sample Lead-ins Based on Task Competencies\n## Appendix C: NBME Retired Item Formats\n## Appendix D: Resources and Additional Reading on Item and Test Development","[{\"question\":\"What is the main purpose of the NBME Item-Writing Guide?\",\"answer\":\"It helps health professions faculty improve the quality of multiple-choice items they write, and it explains item development and item analysis basics, including foundational concepts in psychometrics and measurement.\"},{\"question\":\"What core rules does the guide emphasize for one-best-answer items?\",\"answer\":\"Each item should focus on an important concept, assess application rather than isolated recall, use a lead-in that is focused and answerable from the vignette alone, and keep options homogeneous and plausible to avoid cueing.\"},{\"question\":\"How does the guide address item quality issues and performance review?\",\"answer\":\"It identifies technical item flaws that add irrelevant difficulty or cue testwise examinees, and it covers item analysis using measures such as item difficulty, discrimination, and option behavior across test-taker groups.\"}]","NBME Item-Writing Guide - October 2024 | PDF",1790333122,237]