ABSTRACT
Objectives: The current study aimed to carry out a post-validation item analysis of multiple choice questions [MCQs] in medical examinations in order to evaluate correlations between item difficulty, item discrimination and distraction effectiveness so as to determine whether questions should be included, modified or discarded. In addition, the optimal number of options per MCQ was analysed
Methods: This cross-sectional study was performed in the Department of Paediatrics, Arabian Gulf University, Manama, Bahrain. A total of 800 MCQs and 4,000 distractors were analysed between November 2013 and June 2016
Results: The mean difficulty index ranged from 36.70-73.14%. The mean discrimination index ranged from 0.20-0.34. The mean distractor efficiency ranged from 66.50-90.00%. Of the items, 48.4%, 35.3%, 11.4%, 3.9% and 1.1% had zero, one, two, three and four nonfunctional distractors [NFDs], respectively. Using three or four rather than five options in each MCQ resulted in 95% or 83.6% of items having zero NFDs, respectively. The distractor efficiency was 91.87%, 85.83% and 64.13% for difficult, acceptable and easy items, respectively [P <0.005]. Distractor efficiency was 83.33%, 83.24% and 77.56% for items with excellent, acceptable and poor discrimination, respectively [P<0.005]. The average Kuder-Richardson formula 20 reliability coefficient was 0.76
Conclusion: A considerable number of the MCQ items were within acceptable ranges. However, some items needed to be discarded or revised. Using three or four rather than five options in MCQs is recommended to reduce the number of NFDs and improve the overall quality of the examination
ABSTRACT
To identify the causative agents of otitis media of children aged up to 15 years, and determine the proper antibiotics and compare them with those empirically prescribed by Yemeni pediatricians. A total of 429 bacteriology results of middle ear swabs, agent microorganisms, and their susceptibility to antibiotics of children aged up to 15 years old with otitis media resistant to prescribed antibiotics were collected from three main microbiology lab in Sana 'a city during the period from June 2006 till June 2007. Fifty pediatricians were asked to list their 5 antibiotics of choice in treatment of otitis media to compare empirical prescription with microbiology A total of 429 children were enrolled in this study, 145 [33.8%] of them aged 2 year or less, 101 between 3-5 years [23.5%], while 183 aged 6 years old and above [42.7%]. Males were 266 [62.0%] while 163 [38.0%] were females. The most common pathogens were Staphylococcus aureus [41.7%], Pseudomonas aeruginosa [17.7%], Proteus spp [11.2%] and Hemophilus influenza [7.7%]. Concerning antibiotics, pathogens were more sensitive to ceftriaxone [77.7%] followed by cefotaxime [72.0%], cefuroxime [69.1%], amoxil/clavulanic [57.3%]. Most common empirically prescribed antibiotics were amoxil/clavulanic [92%]. Practicing pediatricians used to prescribe amoxil/ davulanic first and a considerable proportion are prescribing amoxil which is not effective. Staphylococcus aureus, Pseudomonas aeruginosa and Proteus spp. are the most common pathogens associated with otitis media in Yemeni children. Otitis media pathogens are sensitive to ceftriaxone, cefotaxime and amoxil/clavulanic respectively