Summary Validity and Reliability of Scores Obtained on Multiple-Choice Questions: Why Functioning Distractors Matter

Validity of obtained scores is necessary for an assessment instrument and is irrespective of the level of examinees’ education or the domain or subject under assessment. A search of the literature on scholarship of teaching and learning reveals a plethora of studies on the topic, ranging from cultural validity of assessment (Shaw, 1997), to impact of clarity of assessment's design on learners’ performance (Solano-Flores & Nelson-Barber, 2001). In medical education, the desire to yield valid assessment scores is even stronger, since learner competence has immediate and serious implication on patient care. Although the study presented here was conducted in the context of undergraduate medical education, it demonstrates how the multiplechoice question, an assessment instrument prevalent in science and humanities education, can be improved to help educator scholars make more definitive conclusions about competence of learners and effectiveness of curricula