What are distractors in multiple choice questions

  1. Cizek GJ, O'Day DM: Further investigations of nonfunctioning options in multiple-choice test items. Educ Psychol Meas. 1994, 54 (4): 861-872. 10.1177/0013164494054004002.

    Article  Google Scholar 

  2. Downing SM: Assessment of knowledge with written test forms. International handbook of research in medical education. Edited by: Norman GR, Van der Vleuten C, Newble DI. 2002, Dorcrecht: Kluwer Academic Publishers, II: 647-672.

    Chapter  Google Scholar 

  3. McCoubrie P: Improving the fairness of multiple-choice questions: a literature review. Med Teach. 2004, 26 (8): 709-712. 10.1080/01421590400013495.

    Article  Google Scholar 

  4. Schuwirth LWT, Vleuten van der CPM: Different written assessment methods: what can be said about their strengths and weaknesses?. Med Educ. 2004, 38 (9): 974-979. 10.1111/j.1365-2929.2004.01916.x.

    Article  Google Scholar 

  5. Farley JK: The multiple-choice test: writing the questions. Nurse Educ. 1989, 14 (6): 10-12. 10.1097/00006223-198911000-00003.

    Article  Google Scholar 

  6. Haladyna TM, Downing SM: Validity of a taxonomy of multiple-choice item-writing rules. Appl Meas Educ. 1989, 2 (1): 51-78. 10.1207/s15324818ame0201_4.

    Article  Google Scholar 

  7. Haladyna TM, Downing SM: How many options is enough for a multiple-choice test item?. Educ Psychol Meas. 1993, 53 (4): 999-1010. 10.1177/0013164493053004013.

    Article  Google Scholar 

  8. Bruno JE, Dirkzwager A: Determining the optimal number of alternatives to a multiple-choice test item: An information theoretic perspective. Educ Psychol Meas. 1995, 55 (6): 959-966. 10.1177/0013164495055006004.

    Article  Google Scholar 

  9. Lord FM: Optimal number of choices per item – A comparison of four approaches. J Educ Meas. 1977, 14: 33-38. 10.1111/j.1745-3984.1977.tb00026.x.

    Article  Google Scholar 

  10. Tversky A: On the optimal number of alternatives at a choice point. J Math Psychol. 1964, 1 (2): 386-391. 10.1016/0022-2496(64)90010-0.

    Article  Google Scholar 

  11. Aamodt MG, McShane T: A meta-analytic investigation of the effect of various test item characteristics on test scores. Public Pers Manage. 1992, 21 (2): 151-160.

    Article  Google Scholar 

  12. Cizek GJ, Robinson KL, O'Day DM: Nonfunctioning options: A closer look. Educ Psychol Meas. 1998, 58 (4): 605-611. 10.1177/0013164498058004004.

    Article  Google Scholar 

  13. Crehan KD, Haladyna TM, Brewer BW: Use of an inclusive option and the optimal number of options for multiple-choice items. Educ Psychol Meas. 1993, 53 (1): 241-247. 10.1177/0013164493053001027.

    Article  Google Scholar 

  14. Delgado AR, Prieto G: Further evidence favoring three-option items in multiple-choice tests. Eur J Psychol Assessment. 1998, 14 (3): 197-201. 10.1027/1015-5759.14.3.197.

    Article  Google Scholar 

  15. Landrum RE, Cashin JR, Theis KS: More evidence in favor of three-option multiple-choice tests. Educ Psychol Meas. 1993, 53 (3): 771-778. 10.1177/0013164493053003021.

    Article  Google Scholar 

  16. Owen SV, Froman RD: What's wrong with three-option multiple choice items?. Educ Psychol Meas. 1987, 47 (2): 513-522. 10.1177/0013164487472027.

    Article  Google Scholar 

  17. Shizuka T, Takeuchi O, Yashima T, Yoshizawa K: A comparison of three- and four-option English tests for university entrance selection purposes in Japan. LangT. 2006, 23 (1): 35-57.

    Google Scholar 

  18. Sidick JT, Barrett GV, Doverspike D: Three-alternative multiple choice tests: An attractive option. Pers Psychol. 1994, 47 (4): 829-835. 10.1111/j.1744-6570.1994.tb01579.x.

    Article  Google Scholar 

  19. Trevisan MS, Sax G, Michael WB: The effects of the number of options per item and student ability on test validity and reliability. Educ Psychol Meas. 1991, 51 (4): 829-837. 10.1177/001316449105100404.

    Article  Google Scholar 

  20. Trevisan MS, Sax G, Michael WB: Estimating the optimum number of options per item using an incremental option paradigm. Educ Psychol Meas. 1994, 54 (1): 86-91. 10.1177/0013164494054001008.

    Article  Google Scholar 

  21. Rogers WT, Harley D: An empirical comparison of three- and four-choice items and tests: susceptibility to testwiseness and internal consistency reliability. Educ Psychol Meas. 1999, 59 (2): 234-247. 10.1177/00131649921969820.

    Article  Google Scholar 

  22. Tarrant M, Ware J: Impact of item-writing flaws in multiple-choice questions on student achievement in high-stakes nursing assessments. Med Educ. 2008, 42 (2): 198-206.

    Article  Google Scholar 

  23. Tarrant M, Knierim A, Hayes SK, Ware J: The frequency of item writing flaws in multiple-choice questions used in high stakes nursing assessments. Nurse Educ Today. 2006, 26 (8): 662-671. 10.1016/j.nedt.2006.07.006.

    Article  Google Scholar 

  24. Taylor AK: Violating conventional wisdom in multiple choice test construction. Coll Stud J. 2005, 39 (1).

  25. Osterlind SJ: Constructing test items: Multiple-choice, constructed-response, performance, and other formats. 1998, Boston: Kluwer Academic Publishers, 2

    Google Scholar 

  26. Ebel RL, Frisbie DA: Essentials of educational measurement. 1991, Englewood Cliffs, N.J.: Prentice Hall, 5

    Google Scholar 

  27. Precht D, Hazlett C, Yip S, Nicholls J: International Database for Enhanced Assessments and Learning (IDEAL-HK): Item analysis users' guide. 2003, Hong Kong: IDEAL-HK

    Google Scholar 

  28. StatCorp: Stata Statistical Software: Release 9.2. 2005, College Station, Tx: StataCorp LP

    Google Scholar 

  29. Rodriguez MC: Three options are optimal for multiple-choice items: A meta-analysis of 80 years of research. Educ Meas Issues Pract. 2005, 24 (2): 3-13. 10.1111/j.1745-3992.2005.00006.x.

    Article  Google Scholar 

  30. Frary RB: More multiple-choice item writing do's and don'ts. Pract Assess Res Eval. 1995, 4 (11).

  31. Haladyna TM, Downing SM: A taxonomy of multiple-choice item-writing rules. Appl Meas Educ. 1989, 2 (1): 37-50. 10.1207/s15324818ame0201_3.

    Article  Google Scholar 

  32. Case SM, Swanson DB: Constructing written test questions for the basic and clinical sciences. 2001, Philadelphia, PA: National Board of Medical Examiners, 3

    Google Scholar 

  33. Wallach PM, Crespo LM, Holtzman KZ, Galbraith RM, Swanson DB: Use of a committee review process to improve the quality of course examinations. Adv Health Sci Educ. 2006, 11 (1): 61-68. 10.1007/s10459-004-7515-8.

    Article  Google Scholar 

  34. Haladyna TM, Downing SM, Rodriguez MC: A review of multiple-choice item-writing guidelines for classroom assessment. Appl Meas Educ. 2002, 15 (3): 309-334. 10.1207/S15324818AME1503_5.

    Article  Google Scholar 

  35. Masters JC, Hulsmeyer BS, Pike ME, Leichty K, Miller MT, Verst AL: Assessment of multiple-choice questions in selected test banks accompanying text books used in nursing education. J Nurs Educ. 2001, 40 (1): 25-32.

    Google Scholar 

  36. Swanson DB, Holtzman KZ, Clauser BE, Sawhill AJ: Psychometric characteristics and response times for one-best-answer questions in relation to number and source of options. Acad Med. 2005, 80 (10 Suppl): S93-96. 10.1097/00001888-200510001-00025.

    Article  Google Scholar 

  37. Haladyna TM: Developing and validating multiple-choice test items. 2004, Mahwah, NJ: Lawrence Erlbaum, 3

    Google Scholar 

  • The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6920/9/40/prepub


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  Test A Test B Test C Test D Test E Test F Test G Total
No. of items 96 72 86 50 50 60 100 514
No. of examinees 146 74 74 73 73 73 75 588
Mean test score % (SD) 67.7 (9.87) 55.5 (8.52) 69.2 (10.44) 72.0 (10.82) 62.6 (11.28) 67.8 (10.02) 65.6 (11.29) --
Range of test scores (%) 38–89 33–71 38–90 46–94 34–88 35–88 34–89 --
KR20 Reliability .81 .71 .82 .71 .72 .70 .87 --

  1. SD = standard deviation; KR-20 = Kuder-Richardson 20