Guidelines for 2nd edition of 2000 Multiple Choice

Questions (MCQs)
Dear Contributor,

Once again let me congratulate you on your selfless effort and dedication to the first edition of 2000
MCQs in Paediatrics. This book has remained largely successful among resident doctors in the
country and in the West African Sub region. Building on this success and its acceptability, it has
become necessary to publish the 2 nd Edition of this book. Feedback from the field suggests the
addition of explanatory notes to some of the questions. Contributors need to generate a consensus
on this. Therefore, the time has come for us to spare our busy schedules and come up with the 2 nd
edition of 2000 MCQs in Paediatrics.

The 2nd edition should have additional 500 questions and therefore titled: 2500 Multiple Choice
Questions in Paediatrics with some explanatory notes.

Here attached is a list of suggested additional chapters: Emergency Paediatrics, Clinical

Pharmacology.

I call on all contributors to make suggestions on ways to improve on the quality of the 2 nd edition.
Efforts are on the way to enlist contributors from the following countries: Uganda, Kenya, Malawi,
Tanzania, Ethiopia and Ghana.

Here attached is a list of chapters and contributors. Lead contributors for each chapter are
encouraged to recruit and enlist other paediatricians in this regard.

Chapter Content Numb Contributors

er of
questi
ons
Chapter 1 Vital Statistics and Health informatics 80 Dr Ayuba Zoakah
Dr Elon Warnow Isaac
Chapter 2 Medical ethics, communication and counselling 60 Dr Garba Mohammed Ashir
Dr Elon Warnow Isaac
Chapter 3 Human Genetics/Growth & Development 70 Dr Abiola Amaraore
Dr Elon Warnow Isaac
Chapter 4 Perinatology 70 Dr George S Melah
Dr Alfred A. Massa
Dr Idowu Adebara
Dr Elon Warnow Isaac
Chapter 5 Neonate 150 Dr Maria Muktar- Yola
Dr Yaya S. Alkali
Dr Mustapha Bello
Dr Elon Warnow Isaac
Chapter 6 Adolescence 70 Dr Obindo James Taiwo
Dr Nadia Sam
Dr Elon Warnow Isaac
Chapter 7 Vaccinations 50 Dr Olubukola Temitope Idoko
 Dr Elon Warnow Isaac
Chapter 8 Immunologic & Allergic Disorder 60 Dr Gambo Mahmud Jahun
Dr Sunny Ochigbo
Dr Elon Warnow Isaac
Chapter 9 Fluids and electrolyte 65 Dr John Collin
Dr Sunny Ochigbo
Dr Ernest Kolade
Dr Elon Warnow Isaac
Chapter 10 Nutrition and Malnutrition 70 Dr Abiola Amraore
Dr Elon Warnow Isaac
Chapter 11 Infections 300 Dr Lawal Umar Wasiu
Dr Iliya Jalo
Dr Yusuf Jibrin Bara
Dr Emeka Nwolisa
Dr Nanditha Sugandhi
Dr Mustapha Gofama
Dr Elon Warnow Isaac
Chapter 12 Infestation 60 Dr Enobong Ikpeme
Dr Elon Warnow Isaac
Chapter 13 Eye 50 Dr Ali Mshelizar
Dr Elon Warnow Isaac
Chapter 14 Ear Nose and Throat 60 Dr Daniel D. Kokong
Dr Garandawa
Dr Elon Warnow Isaac
Chapter 15 Respiratory System 100 Dr Atana Ewa
Dr Sylvanus Okpe
Dr Elon Warnow Isaac
Chapter 16 Cardiovascular system 100 Prof Bode Thomas
Dr Wilson Sadoh
Dr Christopher Yilgwan
Dr B. Adeola Animasahun
Dr Asani AKTH
Dr Elon Warnow Isaac
Chapter 17 Digestive system 100 Dr Yakubu Mava
Dr Bismarck Eke
Dr Elon Warnow Isaac
Chapter 18 Urogenital System 150 Dr Isaac Ocheke M. Phil
Dr Oluseyi Oniyangi
Dr Hayatu Ahmed
Dr Mohammed Mustapha
Kura
Dr Elon Warnow Isaac
Chapter 19 Blood and Cancer 200 Dr Sylvanus Okpe
Dr Ahmed Iya Gerei
Dr Adamu Danladi Bojude
Dr Ebele Brown
Dr Elon Warnow Isaac
Chapter 20 Endocrine System 100 Dr Saidu Yaya Alkali
Dr Bashir ATBU
Dr Kolade Ernest
Chapter 21 Nervous System 120 Dr Elon Warnow Isaac
Chapter 22 Paediatrics Surgery 80 Dr Sani Adamu
Dr Misauno Micheal Ayedima
Dr L. O Abdulrahman
Dr Benedict Akintibubo
Dr Joseph O. Obande
Chapter 23 Musculoskeletal system 50 Dr Essin Isa Abdulrazaq
Dr Sikiru Alabi
Dr Elon Warnow Isaac
Chapter 24 Reconstructive / Plastic surgery 50 Dr Zainab Y. Kaltungo
Dr Ugochukwu U Nnadozie
Chapter 25 Paediatrics Anaesthesia 30 Dr Yusuf Sambo
Dr Adamu A. Sadiq
Chapter 26 Imaging & Radiodiagnosis 100 Dr Suleiman Tanimu
Dr Nasiru Musa Tahir
Dr Elon Warnow Isaac
Chapter 27 Emergency Paediatrics 50 Dr Elon Warnow Isaac
Chapter 28 Clinical Pharmacology 30

Target dates

Proposed Date Activities Persons Responsible

March/April 2018 Recruitment of contributors Institutional/ Chapter leads
April- September Setting/Development/Editing All contributors
2018 of MCQs
September- Zero draft/ ISBN/Copy right Editor/Editors
November
December 2018 Printing Printer
January 2019 Launching in PANCONF PAN/All contributors
Ibadan
MCQs are difficult to write even for those who are trained in their construction. A good MCQ takes
about one hour to construct and for the examinee 30 secs to answer one mcq. Constructing good
multiple choice items requires time for writing, review, and revision. Several guidelines exist in the
literature for constructing mcqs and contributors are urged to lend themselves to these information.
In 1959, Bloom published taxonomy of cognitive learning, which was described as a hierarchy of knowledge,
comprehension, application, analysis, synthesis, and evaluation. Educators have adopted Bloom’s taxonomy for
test development, and some have simplified and collapsed it into three general levels.

The three levels include the following categories:

(a) Knowledge (recall or recognition of specific information),
(b) combined comprehension and application(understanding or being able to explain in one’s own words
previously learned information and using new information, rules, methods, concepts, principles, laws, and
theories), and
(c) Problem solving (transferring existing knowledge and skills to new situations).
A MCQ should test at the same level of learning as the objective it is designed to assess. Multiple choice
questions can ask learners to interpret facts, evaluate situations, explain cause and effect, make inferences, and
predict results. Multiple choice items addressing complex thinking skills are more difficult than those intended
to survey factual knowledge.
Vocabulary
a. MCQ Stem
b. Distractors/alternatives
The prompt or first part of the question is the stem. The stem should be a question or a partial sentence. A
question stem is preferable because it allows the student to focus on answering the question rather than
holding the partial sentence in working memory and sequentially completing it with each alternative .The
cognitive load is increased when the stem is constructed with an initial or interior blank, so this construction
should be avoided. The stem should be meaningful by itself and should present a definite problem. A stem
that presents a definite problem allows a focus on the learning outcome. A stem that does not present a clear
problem, however, may test students’ ability to draw inferences from vague descriptions rather serving as a
more direct test of students’ achievement of the learning outcome.
Students select from among the options, which include the correct response and the incorrect responses or
distractors

Best Practices
The following tips can help you create multiple choice items that most effectively measure student learning.
 Write the stem first, then the correct answer(s), then the distractor(s).
 The distractor(s) should match the correct answer in terms of length, complexity, phrasing, and style.
 Base each item on a learning outcome.
 Ask a peer to review items if possible
 Allow time for editing and revising
 Minimize the amount of reading required for each item
 Be sensitive to cultural and gender issues
  Keep vocabulary consistent with student level of understanding
 Avoid convoluted stems and options
 Avoid language in the options and stems that gives clues to the correct answer
Writing effective multiple choice item stems:
 Format stems as clearly, concisely phrased questions, problems, or tasks if possible
 If phrasing the stem as a question requires extra words, make the stem  into an incomplete statement
 Include most information in the stem so that the options can be short
 When making the stem an incomplete statement, make sure the options follow the stem in a
grammatically correct manner
 Avoid using negatives in stems when possible
Writing effective multiple choice item options: 
 Make options of similar length and make sure the longest answer is only correct some of the time
 Avoid “all of the above” or  “none of the above”
 Avoid using certain specific language such as “all,” “only”“never,” or “always”
 Avoid negative phrasing where possible for example
o “Which of the following is not true”
o “All of the following are true except”
When negative phrasing is necessary, Not true or Except must be in Italics or capitalize
 Avoid repeating the same words in all of the options by moving the words to the stem
 Arrange options in logical order if possible
 Keep options plausible for students who do not know the correct option
 The alternatives should be presented in a logical order (e.g., alphabetical or numerical) to avoid a bias
toward certain positions.
 Alternatives or options should be homogenous in content
 Avoid complex multiple choice items, in which some or all of the alternatives consist of different
combinations of options.
 Avoid questions of the form “Which of the following statements is correct?
For the 2nd edition of 2000 MCQs, questions can be mixed type including True or False, Best of five, Matching
options, all generated from the stem that include clinical case scenarios and case presentations.

Yours Sincerely,
Dr Elon Isaac. MBBS 1987, FWACP 2000.
Chief Consultant/Senior Lecturer
Head of Department
College of Medical Sciences
Gombe State University/Federal Teaching Hospital, Gombe.