Multiple choice question writing and medical students: a systematic literature review

Background: Multiple-choice question (MCQ) tests have been the standard for ensuring fairness and ease of grading within school curricula for several years. Students, teachers, and researchers alike have developed methods and materials to improve performance on MCQ tests. One practice of interest to the research team is students writing their own multiple-choice questions as a learning methodology. This study intends to review the current literature to assess the validity of student-written MCQs as a study technique. Methods: This literature review was performed following the PRISMA guidelines. Relevant articles were pulled via a systematic search of various databases (Google Scholar, Cochrane, and PubMed) performed on 7.17.2022. Forty-seven non-duplicated articles were extracted. These were then limited, following full text evaluation, to a total of five articles. Results: In three out of the five articles there were positive subjective views of the use of MCQ writing as a method for studying, and one article showed that the students did not feel that the process helped them or provided value. In two of the five articles, data was collected on how MCQ writing worked in comparison with students that were not writing MCQs, and results demonstrated that those students who wrote MCQs more frequently demonstrated better exam scores as compared to those who did not use MCQ writing as a study method or utilized it infrequently. Conclusions: This literature review demonstrated some of the preliminary work that has been done thus far on the utility of MCQ writing as a learning tool in medical education. While still limited in overall understanding of the effects of the use of this method, there remains much promise for its use in the medical student population. It is the hope of the authors that further work be done on this question for the benefits of the students.