Mosab Nouraldein Mohammed HamadYousif Mohammed ELhaj Mohammed AhmmedMohammed Medani Eltayeb Abdullah2023-11-212023-11-212019https://ds.eaeu.edu.sd/handle/10.58971/402Multiple choice questions (MCQs) examinations are well established and widely used in a large number of medical schools(Haladyna, Downing et al. 2002). Multiple choice questions are considered to be the most objective, and valid tool for student assessment (Paxton 2000). Reasons of popularity of MCQs among medical teachers include their ability to test factual recall, interpretation of sets of data and problem solving. Also MCQs test a wide area of knowledge in short period of time and are of easy and objective scoring. Appropriately constructed MCQs result in objective testing that can measure knowledge, comprehension, application, and analysis (Collins 2006). Formats of MCQ are False/true, one best answer, one correct answer, extended matching and interpretative exercise. Strengths of MCQs is useful for outcomes where there are only few possible alternatives, less affected by reading ability, can be answered in reasonable time, easy to score, good concurrent and predictive validity, the face validity is satisfactory if the question is well structured, the content validity is high if questions address important area, reliable, discriminatory, reproducible, cost effective and high on the index of utility. Limitation of MCQs Difficult to write, knowing the false item provide no evidence that student know the correct one . no diagnostic information is provided from incorrect answers, score is influenced by guessing, validity are affected by construction, test low level knowledge-recall and score does not reflect the amount of student achievements. Recent research on multiple choice questions has identified deficiencies of inadequate content-equivalence and item-writer bias. Systematic methods of writing multiple choice questions are being advocated as effective responses (Cox, Irby et al. 2007).other