Illustrated versus non-illustrated anatomical test items in anatomy course tests and German Medical Licensing examinations (M1)

  • Illustrated Multiple-choice questions (iMCQs) form an integral part of written tests in anatomy. In iMCQs, the written question refers to various types of figures, e. g. X-ray images, micrographs of histological sections, or drawings of anatomical structures. Since the inclusion of images in MCQs might affect item performance we compared characteristics of anatomical items tested with iMCQs and non-iMCQs in seven tests of anatomy courses and in two written parts of the first section of the German Medical Licensing Examination (M1). In summary, we compared 25 iMCQs and 163 non-iMCQs from anatomy courses, and 27 iMCQs and 130 non-iMCQs from the written part of the M1 using a nonparametric test for unpaired samples. As a result, there were no significant differences in difficulty and discrimination levels between iMCQs and non-iMCQs, the same applied to an analysis stratified for MCQ formats. We conclude that the illustrated item format by itself does not seem to affect item difficulty. The present results are consistent with previous retrospective studies which showed no significant differences of test or item characteristics between iMCQs and non-iMCQs.

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Author:Olaf Bahlmann
Pubmed Id:
Parent Title (English):GMS journal for medical education
Place of publication:[Düsseldorf]
Document Type:Article
Year of Completion:2018
Date of first Publication:2018/05/15
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2018/12/11
Tag:Examination questions; anatomy; anatomy and histology; educational measurement; medical illustration
Issue:2, Doc25
Page Number:5
First Page:1
Last Page:5
© 2018 Bahlmann. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0