Two investigations involving 700 candidates for medical specialty certification suggest that test items with only 4 options perform as well as the same items with 5 options. Results also suggest that five-option multiple-choice items can be reduced to four-option items by removing a nonfunctioning item. (SLD)

Results from 627 examinees taking a health sciences certification examination suggest that test items written purposefully to assess higher order cognitive skills do not provide evidence of assessing different levels of cognitive processing. Results do not support continuing use of a hierarchical cognitive classification dimension for the test…

Performance of a common set of test items on an examination in which the order of options for one test form was experimentally manipulated. Results for 759 medical specialty board examinees find that reordering item options results in significant but unpredictable effects on item difficulty. (SLD)

A commonly accepted rule for developing equated examinations using the common-items non-equivalent groups (CINEG) design is that items common to the two examinations being equated should be identical. The CINEG design calls for two groups of examinees to respond to a set of common items that is included in two examinations. In practice, this rule…