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Multiple choice/(multiple) true false

Multiple-choice: This is a type of assessment where students select the best answer to a question from a list of four or five alternatives. A multiple-choice assessment often consists of a large number of questions and can be used to cover the entire curriculum in the course.

Variations of multiple-choice are Multiple-response, True/false questions and multiple true/false questions.

Multiple-response: For each question the student has to pick one or more correct answers, which makes the assessment (and scoring) harder.

True/false questions: The question contains an introductory text followed by one statement to which the student has to answer true or false.

Multiple true/false: The question contains an introductory text followed by a number of independent statements. 

Grading of multiple choice questions can be done automatically with software, if the assessment is done in a digital format.

A key challenge in making great multiple choice questions is writing plausible wrong answers. This will require time and effort.

It is possible to involve students in writing multiple choice questions, for instance in PeerWise, which is free and has elements of gamification. You can find examples of multiple-choice questions in PeerWise here.

Examples from AU

SCIENCE AND TECHNOLOGY (formerly): International Biology Olympiad 2015 (IBO2015)

Multiple true/false with four independent statements

An alteration of the well known multiple choices question is multiple true/false. An extended version is shown here: multiple true/false with four independent statements.

Here each question contains an introduction and a figure or table. The student has to interpret the information and answer true or false to each of the four independent statements. The focus is on reasoning and creative thinking, and less on memorization and root knowledge.  

The example below is one of the 98 questions used during the International Biology Olympiad IBO2015 where 75% of all theoretical questions were based on research from the last five years, and about 20% on research from 2015.

During IBO2015 the scoring was performed as described below:

Each correctly answered question gives you 1 point, i.e. all four statements are correct.

  • If only three statements in a question are correct, you get 0.6 points
  • If only two statements in a question are correct you get 0.2
  • If only one statement in a question is correct you get 0.0
  • If no statements in a question are correct, you do not get any points.

Example of a multiple choice item

Question 25 – Ecology

The fragility of an ecological food chain is examined in an atoll, where native forest was replaced by coconut palms (Fig.). This created a problem for seabirds which could not nest in palms.

Indicate if each of the following statements is true or false.


Bird presence benefits manta rays

Palm growing might harm corals in the atoll

If forest was cleared and land instead used for intensive modern farming with fertilizers, manta rays might disappear from the coast

The food chain includes only top-down effects, and no bottom-up effects

HEALTH: Inflammation

Faculty: Health
Department: Department of Clinical Medicine
Course: Inflammation
Place: 1st semester
Course responsible: Jesper Stentoft

A 2 hour on site written exam with aids (books and internet access).

The test format is multiple choice questions, and 80 multiple choice items are administered to secure broad sampling of subject knowledge. The students access the password protected exam web site on their own devices, and all responses are recorded in real time and scored electronically, allowing for extensive quality control of the test. The main aim of the test is to assess applied knowledge rather than factual knowledge. For this purpose examinees are examined in important and authentic clinical cases. The constellation of information in the cases to be analysed by examinees secures the assessment of transferral of textbook facts to relevant clinical situations and professional practice. The answer format is ‘One-Best-Answer’, so the answer choices supplied are typically situated on a continuum of correctness.

Important ‘take home’ principle: Sufficient representation course content in a test (e.g. broad sampling) is always important for test reliability and validity, because the test performances of our examinees are content/topic specific.

Example of a multiple choice item

A 27 year old female originating from North Africa presents to her GP complaining of cystitis symptoms. The urine is examined for bacterial growth and treatment with sulfamethizole is commenced. One week later she returns, this time complaining of dizziness, heart palpitations, and shortness of breath. On inspection you notice a yellow discoloration of her eyes.

What is the most likely diagnosis?

A. The patient has a glucose-6-phophat dehydrogenase deficiency
B. The patient has sickle cell anaemia
C. The patient has beta thalassemia