10 Steps to writing a good quality SBA question

What is a Single Best Answer (SBA) question?

Clinical scenario (stem), a single line stating the question itself (the lead in) and a list of 5 options (one correct answer and four distractors).

10 Steps to writing a good quality SBA Question

1. Identify a key domain/topic relevant to students’ curriculum to focus question on

2.  Create a clinical scenario (called ‘the stem’) for your question based on this domain

  • Describe the case in 30-100 words
  • Write in the present tense
  • Use simple language – short sentences, simple words, cut out unnecessary details
  • Do not use patient names
  • N.B. Even if your ‘lead-in’ is testing knowledge of basic sciences, a clinical stem should still be written as this gives the question a clinical context and increases face validity of the assessment

3. Write a ‘lead-in’ – a single line stating the question itself

    • Avoid negative phrasing and questions based on bad practice

4. Create a list of 5 options

    • One correct answer, four distractors
    • Should be homogenous in length and content (i.e. all diagnoses, investigations or treatments)
    • Relevant to stem and lead-in
    • Realistic
    • Options ordered logically (alphabetically or numerically)

5. Perform the cover test!

    • Student should be able to arrive at correct answer without seeing the options
    • Therefore avoid statements like ‘which of the following statements is correct’

6. Structure your question according to the ‘House Style.’

    • Ensures format of all questions in bank are homogenous

7. Avoid abbreviations when possible

8. Clearly state correct answer, justification and referenced relevant guidelines

9. Check you’ve not fallen into a common pitfall – see below list: WHAT TO AVOID

10.  Review, refine and edit question with experienced question writers
why not come to our exciting Question Writing workshop on the 28th of November!

What to Avoid:

  • “Which of the following is true/correct”
  • “Which of the following is correct EXCEPT”
  • “Which of the following should not be done”
  • “Which of the following is not a feature of”
  • Avoid extremely long questions
    – takes too much time to read!

For more information:

See video by Dr David Kluth: Writing MCQs video

Join us for our Question Writing Workshop on the 28th of November

Here are some photos from last year’s event!

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