CPD Articles

The pearls and pitfalls of setting high-quality multiple choice questions for clinical medicine

Mergan Naidoo
South African Family Practice | Vol 65, No 1 : Part 3| a5726 | DOI: https://doi.org/10.4102/safp.v65i1.5726 | © 2023 Mergan Naidoo | This work is licensed under CC Attribution 4.0
Submitted: 14 February 2023 | Published: 29 May 2023

About the author(s)

Mergan Naidoo, College of Family Physicians of South Africa, Discipline of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa


Multiple choice question (MCQ) examinations have become extremely popular for testing applied knowledge in the basic and clinical sciences. When setting MCQ examinations, assessors need to understand the measures that improve validity and reliability so that the examination accurately reflects the candidate’s ability. This continuing medical education unit will cover the essentials of blueprinting an exam, constructing high-quality MCQs and post hoc vetting of the exam. It is hoped that academics involved in assessments use the content provided to improve their skills in setting high-quality MCQs.


multiple choice questions; MCQs; single best answer questions; blueprinting; post hoc analysis


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