NBME Item-Writing Guide for Health Sciences

This guide serves as a comprehensive resource for faculty members involved in the development of written test questions within health sciences education. It outlines the process of constructing high-quality multiple-choice items (MCQs) that accurately assess knowledge and skills in both foundational and clinical sciences. The manual details various aspects of item writing, including the importance of aligning test content with educational goals, addressing technical item flaws, and conducting thorough item analysis. It emphasizes the necessity of sampling content broadly to ensure reliable and valid assessments. Additionally, the guide introduces new content on incorporating patient characteristics and alternate item types, reflecting ongoing innovations in test development. The intended audience primarily includes faculty teaching health sciences students, although the principles discussed are applicable across various competency levels and health care professions. Overall, this manual aims to enhance the quality of assessments and support effective teaching and learning in health professions education.