Chandrasekharan Nair K^1*, Pradeep C Dathan², T Mohan Kumar³ and D Bheemalingeswara Rao⁴

¹Professor Emeritus, Department of Prosthodontics, Sri Sankara Dental College, Akathumuri, Thiruvananthapuram, Kerala, India
²Professor and Head of the Department of Prosthodontics, Sri Sankara Dental College, Akathumuri, Thiruvananthapuram, Kerala, India
³Director, Centre for Temporomandibular Disorders, Kunnukuzhi, Trivandrum, Kerala, India
⁴ Professor and Head of the Department of Prosthodontics, Vishnu Dental College, Bhimavaram, AP, India

*Corresponding Author: Chandrasekharan Nair K, Professor Emeritus, Department of Prosthodontics, Sri Sankara Dental College, Akathumuri, Thiruvananthapuram, Kerala, India.

Received: July 03, 2026; Published: August 03, 2026

Multiple-choice questions (MCQs) are among the most widely used assessment tools in health professions education because of their objectivity, reliability, ease of scoring, and ability to sample a broad range of knowledge and cognitive skills. This review provides an overview of the historical evolution of MCQs, the different formats currently in use, and the principles underlying effective item construction. Common item-writing flaws and methods of item analysis used to evaluate question quality are discussed. The advantages and limitations of MCQs are examined, highlighting their strengths in providing standardized, objective, and reliable assessment, while acknowledging concerns related to cueing effects, guessing, and overemphasis on factual recall. Recent developments, including computerized item banks, computer-adaptive testing, and artificial intelligence-assisted item generation, are also reviewed. Although these emerging technologies are expected to enhance the efficiency and quality of assessment, careful adherence to established principles of test construction and validation remains essential to maintain the validity, reliability, and educational value of MCQs. With continued technological advances, MCQs are expected to remain a cornerstone of knowledge assessment and clinical reasoning in medical and dental education.

Keywords: Multiple-Choice Questions; Assessment; Medical Education; Dental Education; Item Analysis; Artificial Intelligence

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Citation

Citation: Chandrasekharan Nair K. et al. “Best Practices in Designing Multiple Choice Questions – A Review". Acta Scientific Dental Sciences 10.8 (2026): 35-49.

Copyright

Copyright: © 2026 Chandrasekharan Nair K. et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.