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高雄醫學大學e快報 第139期　 分享園地【醫學教育】 == '''選擇題(MCQs)命題時注意事項的範例''' == 醫學院 劉克明 多個答案選項的測驗題 (以下簡稱選擇題，Multiple Choice Questions, MCQs)，其基本結構是一個題幹及/或一個導入敘述（a stem and/or a lead-in statement）。可選答的項目通常為四或五個。筆者謹延續上篇文章，再進一步分別提出選擇題 (MCQs) 命題時，宜注意事項的範例如下。 1. 題幹應該是有意義的，而且呈現一個明確的問題（The stem should be meaningful and present a define problem）: Ex:North America _____. A. Is a flat and rich country, B. Imports coffee from the Brazil, C. Was settled mainly by colonists from Asia. D. Is cross-cutted by I-80 Free Way. *問題: 題幹的意義不明，無法選出正確的答案。 2. 題幹應該避免不相關的文字敘述（The stem should be free from irrelevant materials ） Ex: Most of North America was settled by British colonists. How would you account for this: A. Seeking adventure, B. Seeking religious freedom, C. Seeking wealth, D. Seeking health. Ex: British colonists settled in North America in search of _____. A. Adventure, B. Religious freedom, C. Wealth, D. Health. *上面兩範例，何者佳? 理由為何? 3. 題幹宜避免用否定句（Avoid negative stem ）: Ex: Which procedure is not recommended for the victim of an accident? _____. A. do not leave the victim alone, B. do not move the victim, C. notify the police, D. do not talk to the victim, E. do not phone for an ambulance. *題幹用否定句，選項也用否定句，易造成學生無法正確判斷。 4. 題幹應指向一個最好的或正確答案（An item should contain only one best or correct answer） Ex: The Kaohsiung Medical University neighbors by which one of the following: A. Shieh-Chuan Primary School, B. Shieh-Chuan 1st. Road, C. San-Ming Secondary School, D. Carrefour Department Store, E. Love River. *缺點為題幹指向不明確。 5. 題幹與答案選項的文法應該要一致（Alternatives should be grammatically consistent with the stem） Ex: An electric transformer can be used _____ A. in the digital camera, B. as an emergence generator, C. for storing up electricity, D. to increase the voltage of alternating current, E. alternating current is changed to divert current. *缺點為選項 E 文法與題幹不一致。 6. 所有的答案選項應該是 「似真實的」（All distracters should be plausible） Ex: 現今對於頭頸部腫瘤重建的方式，大多選用 Free flap reconstruction，而不以Local or pedicled flap reconstruction的趨勢，稱作Reconstructive _____. A. ladder, B. escalator, C. elevator, D. helicopter, E. instructor. *優點為答案選項 ”似是而非的”，學生須用心選答。 7. 在題幹中避免提供線索（Avoid guiding clues in the stem） Ex: A fertile area in the desert in which the water table reaches the ground surface is called an ______ A. mirage, B. oasis, C. water hole, D. polder, E. septum. *缺點為題幹中已經提供線索“an”. 8. 答案選項的數據不可重疊（Options should not overlap）The average height of an American male is ___: A. less than 5 foot 3 inches, B. less than 5 foot 5 inches, C. more than 5 foot 7 inches, D. more than 5 foot 9 inches, E. between 5 foot 6 inches and 5 foot 9 inches. *缺點為選項的數據明顯重疊。 9. 答案選項的數據，宜依一定明確的順序排列（Place numerical options in numerical order- if answer the student’s time） Ex: The average weight of adult male brain is _____. A. 1200 mg, B. 1000 mg, C. 1600 mg, D. 1300 mg. E. 1450 mg. *缺點為答案選項的數據未按小大順序排列。 10. 答案選項避免以上皆是或是以上皆非 (Avoid “all of the above” or “none of the above”) Ex: The heart is ______. A. located in middle mediastinum, B. consisted of 2 atria and 2 ventricles, C. supplied by coronary arteries, D. innervated by cardiac ganglia, E. “All of the above”. *缺點為學生只要看前兩項答案即可跳選到最後的選項。 11. 避免不明確的名詞，例如有時候、時常、往往等名詞，這些字的定義不清楚 （Avoid the definition is ambiguous） Ex: Sometimes, the hydrocephalus is caused by ____. A. Congenital atresia of cerebral aqueduct, B. Obstruction of cerebral aqueduct by bacteria, C. Closure of Foramen Magendia, D. Compressed cerebral aqueduct by tumor, E. Failure of drainage of CSF into superior saggital sinus. *缺點為題幹之Sometimes定義不清楚，而且病人年齡、病情皆未知，無法選答。 12. 答案選項的長度與形式宜一致或類似（Ensure all options are similar in length and form） Ex. What is the fermentation? A. Many antibiotics are produced by fermentation. B. The breakdown of sugars by bacteria and yeasts using a method of respiration without oxygen. C. The fermentation can be accelerated by heating. D. A chemical change whereby a complex organic compound is decomposed by the action of an enzyme, usually supplied by a micro-organism. E. All wines were fermentated. *缺點答案選項的長度與形式不一致，可能造成有暗示之嫌疑，而且題幹不明確。 13. 題幹與答案選項皆不要應用錯別字，故意誤導學生選答: Ex: Who wrote “Kiddnapped”? A. R. L. Stevenson, B. Robert Palmer, C. S.U. Stephenson, D. William Stevenson, E. None of the above. *缺點為題幹用錯字 “:Kiddnaped”，無法作答。 結論： 選擇題的優點 (Advantages of MCQs)為: #題目可依評量學生的不同認知的層級而設計， #容易出題，利用電腦，即可容易計算成績，而且評量結果可迅速提供回饋給教師與學生， #可利用統計分析題目之難易度，題目可以再重覆利用或建立題庫。 命題時須考量之重點己在本文所述，筆者建議最理想的 MCQs的各答案選項是 「似是而非」 的，亦即是對的敘述，但並不是答案（Correct statements that do not answer the question are often plausible distractions），正確回答問題的最佳答案才是真正的答案。 參考文獻: Dr. Sean McAleer. #Six key questions to ask regarding assessment. #MCQs- Single best answer MCQs and how to write them Discovery Course in Medical Education. April 20, 2009. [[enews139]] [[Category:分享園地]] [[Category:醫學教育]] [[Category:劉克明]]

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