Are multiple-choice questions a good tool for the assessment of clinical competence in Internal Medicine?

  • Flavio Tangianu Internal Medicine, S. Martino Hospital, Oristano, Italy.
  • Antonino Mazzone Medical Department, Internal Medicine, ASST Ovest-Milanese, Legnano (MI), Italy.
  • Franco Berti Internal Medicine, S. Camillo Forlanini, Roma, Italy.
  • Giuliano Pinna Internal Medicine, Asti, Italy.
  • Irene Bortolotti Managing Director-Planning Congressi, Bologna, Italy.
  • Fabrizio Colombo Internal Medicine, Niguarda Ca’ Granda Hospital, Milano, Italy.
  • Carlo Nozzoli Internal Medicine and Emergency, Careggi Hospital, Firenze, Italy.
  • Micaela La Regina Internal Medicine, S.S. Risk Management, Presidio Ospedaliero Unico del Levante Ligure, La Spezia, Italy.
  • Antonio Greco Geriatric Department, Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
  • Cristina Filannino Department of Government, Health and not for profit, Luigi Bocconi University, Milano, Italy.
  • Mauro Silingardi Internal Medicine, Bologna, Italy.
  • Roberto Nardi | Internal Medicine, Bologna, Italy.


There are many feasible tools for the assessment of clinical practice, but there is a wide consensus on the fact that the simultaneous use of several different methods could be strategic for a comprehensive overall judgment of clinical competence. Multiple-choice questions (MCQs) are a well-established reliable method of assessing knowledge. Constructing effective MCQ tests and items requires scrupulous care in the design, review and validation stages. Creating high-quality multiple-choice questions requires a very deep experience, knowledge and large amount of time. Hereby, after reviewing their construction, strengths and limitations, we debate their completeness for the assessment of professional competence.



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Multiple-choice questions, clinical competence, pass mark criteria.
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How to Cite
Tangianu, F., Mazzone, A., Berti, F., Pinna, G., Bortolotti, I., Colombo, F., Nozzoli, C., La Regina, M., Greco, A., Filannino, C., Silingardi, M., & Nardi, R. (2018). Are multiple-choice questions a good tool for the assessment of clinical competence in Internal Medicine?. Italian Journal of Medicine, 12(2), 88-96.

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