An Evidence-Based Approach to Constructing Multiple-Choice Test Questions for Knowledge Assessment.

BACKGROUND: This article provides nursing educators practical tips and evidence-based strategies for effective construction of multiple-choice questions (MCQs). Well-designed MCQs that align with the intended learning objectives are critical for implementing sound assessment practices. METHOD: This article offers a step-by-step approach to test construction, starting with the assessment blueprint and followed by important considerations when writing the specific components of the MCQ. RESULTS: Appropriate inclusion of clinical context in the MCQ and a description of common flaws to avoid, with suggested remedies, are also addressed. CONCLUSION: Ultimately, the goal of this article is to equip nurse educators with the foundational tools to create high-quality MCQs that effectively assess knowledge acquisition by learners. [J Contin Educ Nurs. 2024;55(6):289-296.].

Evaluating the Quality of Multiple-Choice Test Questions in the Postlicensure Environment.

BACKGROUND: Multiple-choice test questions are among the main measures of knowledge used by educators in the postlicensure environment; however, these tests are often constructed in the absence of guidelines or the means to evaluate examination quality after administration. METHOD: Previously, guidance was provided on constructing quality test items. Here we present instruction for professional development specialists to use postadministration test data for an item analysis, providing insight on test flaws and opportunities for iterative examination improvement. RESULTS: The topics of item difficulty, index of discrimination, and distractor analysis are covered for independent analysis, and topics such as reliability are addressed for those who have access to a formal program. CONCLUSION: Three levels of strategies are described: using a learning management system for item analysis, using free open-source software, and using a minimal standards method of evaluating test items. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

Using Performance Improvement Methods to Evaluate Processes for Writing Multiple-Choice Test Questions in the Postlicensure Clinical Environment: A Case Study.

BACKGROUND: This article is the last of a four-part series to guide educators on the construction and evaluation of multiple-choice test items in the post-licensure environment. Previous articles in this series described the problem and the mechanics of test item construction and evaluation. METHOD: A replicable strategy for evaluating the organizational process for constructing multiple-choice test questions is provided. Steps taken to create change are described; work tools are provided. RESULTS: Guidance and training are needed to create multiple-choice test questions. Many educators have not had training in item construction. Educators welcomed training. Personalized mentorship resulted in improvement. Asynchronous learning alone was helpful and well received and improved self-perceived knowledge, yet fell short of achieving competence. CONCLUSION: Voluntary training may not be adequate to assure enculturation of best practices without accountability standards and monitoring. Future research is indicated to assess the situation and provide national standards for adoption within health care organizations. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

Oligodendrocyte differentiation of induced pluripotent stem cells derived from subjects with schizophrenias implicate abnormalities in development.

Abnormalities of brain connectivity and signal transduction are consistently observed in individuals with schizophrenias (SZ). Underlying these anomalies, convergent in vivo, post mortem, and genomic evidence suggest abnormal oligodendrocyte (OL) development and function and lower myelination in SZ. Our primary hypothesis was that there would be abnormalities in the number of induced pluripotent stem (iPS) cell-derived OLs from subjects with SZ. Our secondary hypothesis was that these in vitro abnormalities would correlate with measures of white matter (WM) integrity and myelination in the same subjects in vivo, estimated from magnetic resonance imaging. Six healthy control (HC) and six SZ iPS cell lines, derived from skin fibroblasts from well-characterized subjects, were differentiated into OLs. FACS analysis of the oligodendrocyte-specific surface, glycoprotein O4, was performed at three time points of development (days 65, 75, and 85) to quantify the number of late oligodendrocyte progenitor cells (OPCs) and OLs in each line. Significantly fewer O4-positive cells developed from SZ versus HC lines (95% CI 1.0: 8.6, F1,10 = 8.06, p = 0.02). The difference was greater when corrected for age (95% CI 5.4:10.4, F1,8 = 53.6, p < 0.001). A correlation between myelin content in WM in vivo, estimated by magnetization transfer ratio (MTR) and number of O4-positive cells in vitro was also observed across all time points (F1,9 = 4.3, p = 0.07), reaching significance for mature OLs at day 85 in culture (r = 0.70, p < 0.02). Low production of OPCs may be a contributing mechanism underlying WM reduction in SZ.