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Date Updated: March 26, 2018

Item Writing Manual

Constructing Written Test Questions For the Basic and Clinical Sciences

“Constructing Written Test Questions for the Basic and Clinical Sciences” (4th edition) is an item-writing manual published by the National Board of Medical Examiners® (NBME®). The manual 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:

Permission to copy and distribute this document is granted by the National Board of Medical Examiners provided that (1) the copyright and permission notices appear on all reproductions, (2) use of the document is for non-commercial educational and scientific purposes only, and (3) the document is not modified in any way. Any rights not expressly granted herein are reserved by the National Board of Medical Examiners. If you have questions regarding permission to copy this document, please send an e-mail to the educatorguide@nbme.org.

The manual is in Adobe® Portable Document Format (PDF). Adobe® Reader® can be installed on your computer from the Adobe website.


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