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Date Updated: March 27, 2018

NBME Item Writing Services

The NBME offers a variety of educational materials and instructional opportunities to help enhance the quality of test items used by educators and assessors in the healthcare professions around the world.

Item Writing Manual

The NBME's Item Writing Manual, Constructing Written Test Questions for the Basic and Clinical Sciences, is intended to guide educators of healthcare professions in writing high-quality, multiple-choice questions (MCQs) related to the foundational and clinical sciences. It covers the development of MCQs, common flaws related to item (question) development, and the basics of item analysis. Also, special attention is given to rules for writing one-best-answer questions in the clinical vignette format. Download the 4th edition of this guide.

You can download the manual in Spanish and Russian by clicking here.

Online Interactive Item Writing Tutorial

NBME's Writing Multiple Choice Questions: An Introductory Tutorial is a self-paced interactive tutorial that provides a foundation for writing quality multiple-choice questions. This tutorial is designed to introduce some of the main principles of item writing to individuals who write questions for examinations in the field of medicine and across the range of health professions.

Featured topics include:

  • the anatomy of an item
  • basic rules for writing good stems and options
  • characteristics of a quality "best-answer" item
  • writing items to assess clinical reasoning
  • common item flaws
  • strategies for evaluating test items

The tutorial is organized into sections so that you can complete only a portion of it and easily return later; the entire tutorial takes about 45 minutes to complete. You can access the tutorial at: www.nbme.org/IWTutorial

Item Writing Workshops

The NBME is pleased to offer item writing workshops to groups of medical faculty, educators of healthcare disciplines, and bodies that assess or certify the competence of healthcare providers. For decades, members of NBME's professional test development staff have served as a resource for those who seek to improve their test questions and materials. NBME staff will plan and facilitate a workshop to the specific needs of your school or assessment body, tailoring examples and exercises to align with your healthcare discipline. Workshops are available globally on a year-round basis and can take place at your school campus or other location. To request a workshop, please visit our sign-up page.


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