Faculty Development Resources
Teaching Skills
Problem Based Learning
Writing Test Questions
Question or Item Templates
The overall structure of an item can be depicted by an item template. You can typically generate many items using the same template. For example, the following template could be used to generate a series of questions related to gross anatomy:
A (patient description) is unable to (functional disability). Which of the following is most likely to have been injured?
This is a question that could be written using this template:
A 65-year-old man has difficulty rising from a seated position and straightening his trunk, but he has no difficulty flexing his leg. Which of the following muscles is most likely to have been injured?
*A. Gluteus maximus
B. Gluteus minimus
C. Hamstrings
D. Iliopsoas
E. Obturator internus
Many basic science questions can be presented within the context of a patient vignette. The patient vignettes may include some or all of the following components:
- Age, Gender (eg, A 45-year-old man)
- Site of Care (eg, comes to the emergency department)
- Presenting Complaint (eg, because of a headache)
- Duration (eg, that has continued for 2 days).
- Patient History (with Family History ?)
- Physical Findings
- +/- Results of Diagnostic Studies
- +/- Initial Treatment, Subsequent Findings, etc.
Additional templates:
- A (patient description) has a (type of injury and location). Which of the following structures is most likely to be affected?
- A (patient description) has (history findings) and is taking (medications). Which of the following medications is the most likely cause of his (one history, PE or lab finding)?
- A (patient description) has (abnormal findings). Which [additional] finding would suggest/suggests a diagnosis of (disease 1) rather than (disease 2)?
- A (patient description) has (symptoms and signs). These observations suggest that the disease is a result of the (absence or presence) of which of the following (enzymes, mechanisms)?
- A (patient description) follows a (specific dietary regime). Which of the following conditions is most likely to occur?
- A (patient description) has (symptoms, signs, or specific disease) and is being treated with (drug or drug class). The drug acts by inhibiting which of the following (functions, processes)?
- A (patient description) has (abnormal findings). Which of the following (positive laboratory results) would be expected?
- (time period) after a (event such as trip or meal with certain foods), a (patient or group description) became ill with (symptoms and signs). Which of the following (organisms, agents) is most likely to be found on analysis of (food )?
- Following (procedure), a (patient description) develops (symptoms and signs). Laboratory findings show (findings). Which of the following is the most likely cause?
- A (patient description) dies of (disease). Which of the following is the most likely finding on autopsy?
- A patient has (symptoms and signs). Which of the following is the most likely explanation for the (findings)?
- A (patient description) has (symptoms and signs). Exposure to which of the (toxic agents) is the most likely cause?
- Which of the following is the most likely mechanism of the therapeutic effect of this (drug class) in patients with (disease)?
- A patient has (abnormal findings), but (normal findings). Which of the following is the most likely diagnosis?
