Table 1.

Comparison of item-writing flaws in pre-and postworkshop multiple-choice questions

	Item-writing flaw	Preworkshop (n=133), n (%)	Postworkshop (n=137), n (%)
1	Negative questions. e.g., Which ONE of the following is NOT a characteristic…	9 (6.8)	10 (7.3)
2	“EXCEPT” marked question	32 (24.1)	9 (6.6)*
3	Usage of ambiguous (e.g., frequently, often, occasionally) or absolute terms (e.g. almost, never, frequent)	11 (8.3)	4 (2.9)*
4	A word in the stem repeated in the option(s)	-	1 (0.70)
5	Options are not uniform/heterogeneous	36 (27.1)	8 (5.8)*
6	Has a single long option, which is the correct answer	2 (1.5)	3 (2.2)
7	Uses “all of the above” or “none of the above” option	4 (3.0)	3 (2.2)
8	Options are not in a chronological order	6 (4.5)	4 (2.9)
9	There is more than one correct answer	3(2.3)	-
10	Options are overlapping	4 (3.0)	-
11	Stem is not clear	25 (18.8)	33 (24.1)
12	Answer is hinged to another question	-	-
13	Is a true or false type of question	7 (5.3)	4 (2.9)
14	Case-scenario, if used; is not related to the question	-	-
15	Does not fulfil the cover test, i.e., if you cover the options, you cannot answer the questions	91 (68.4)	83 (60.6)
16	Key not provided	18 (13.5)	29 (21.2)

*P<0.05