Question banks in medical education – An overview

Setting up a Question bank-process

The questions that go into the bank must be prepared meticulously.^[2] Questions must be valid and appropriate to the intended purpose. Seven steps must be followed before choosing the questions that go into a question bank.

• 1.

  Construct questions must be created and reviewed carefully for the contents, structure clarity and expected response(s). In the case of MCQs’, the stem, alternatives, and the key are scrutinised to avoid mislead and confuse the students. The questions should be such that they can differentiate between those who have learned as opposed to those who have not.

• 2.

  Blueprinting: The questions must also conform to the desired format (blueprint), especially if they are meant for assessment.

• 3.

  Pre-validate: The questions must be prevalidated by a team of subject experts who will look for clarity, unambiguity, appropriateness of the questions and functionality of the distractors. Most importantly, the source of information must be given for checking and counterchecking.

• 4.

  Administer: After creating the questions, they must be administered to a group of students.

• 5.

  Post-validate: The questions are then item analysed, and the final set of questions is chosen after discarding the unsuitable and inappropriate ones.

• 6.

  Create: The bank is created in any mode – books, online software apps, etc.

• 7.

  Update: The questions are periodically reviewed, updated, and upgraded once in 3–5 years.

Advantages – Learner

The focus is on pedagogy question banks, which are powerful tools for students to learn at their own pace. Students participate actively in learning rather than passively listening or seeing educational videos. They are a precious supplement to conventional learning and teaching methods. With the availability and accessibility of a wide variety and formats of question banks, students can choose question banks according to their needs. For example, the choice of students preparing for an entrance exam will differ from those who want to use them for formative learning. They can repeatedly access and practice them to improve their performance. They can have a better comprehension of the subject with repeated practice. They can identify their weak points and focus on them. Practice makes a man perfect. It is an efficient way of learning. It helps in self-assessment and improves their professionalism. Case-based scenarios enable them to develop their analytical skills. Students are also exposed to a broad spectrum of questions and can pursue intelligence beyond the scope of their curriculum. This helps them to perform better in examinations. Students can also participate in generating question banks.^[3,4] They will become more involved in learning if they do so and will be valuable in places with a faculty shortage. A survey from 2 Australian Universities found that students preferred face-to-face lectures for learning new concepts but question banks for revising. Repeated self-assessment and testing help in retentive memory and improve performance. Surveys have shown that question banks are one of the students’ most preferred revision methods.^[5] It was observed that the performance of students was better in USMLE step 1 when practice questions were used by them for preparation ^[6]

Advantages - Teachers/Educators

It is a humongous task for teachers to teach and assess students, especially when the training and the curriculum increase exponentially. Creating Question banks helps teachers focus on essential areas of a topic to be stressed while teaching. Preparing questions for a bank enhances their skill in reviewing and item writing. It also helps them to keep in touch with the current trends and changing perspectives in their field.

It aids in both formative and summative assessment of students. Feedback helps students overcome their weak points during constructive assessment by focusing more on them. Using Question banks in summative assessment makes the assessment more uniform, standardised, objective and consistent. It reduces the time and effort in conducting assessments. Several question papers can be set with jumbled-up questions from the same source. Analysing students’ performance helps evaluate a program’s success and make policy decisions. It enables educators to analyse the performance of a broad spectrum of students across different difficulty levels. Exposing students to other assessment formats helps them perform better in exams. Updated questions and answers also help educators keep current with current trends and perspectives.