Writing Multiple Choice Test Items - The Stem

The stem furnishes introductory information and enough content to clue for the response. It may be constructed as either a direct question or an incomplete statement. Questions are preferable, as these are easier to read. If an incomplete statement is used, blanks should be placed at the end of the stem, not in the middle or at the beginning.

The stem should contain a subject and a verb. A quality stem is a coherent sentence that is clear and precise and represents a complete thought. It should not be overly wordy but contain only the language necessary to present a singular objective.

The stem should address only one problem or question. Unnecessary information should be avoided, as this can confuse the test taker. However, it may be useful to have one or two introductory sentences in the stem to help clarify the item.

The stem should be worded in such as way as to query one correct answer. If there is more than one correct answer among the responses, "which of the following" should be added to the stem. Additionally, qualifiers such as best or most should be underlined or boldened, to alert the student.

When examinees are finished reading the stem, they should have sufficient information to clearly know what the item is asking and to choose the correct answer.

Pitfalls to avoid in stem creation:

Negative stems. A common example is the "all of the following are true except" question. These types of multiple-choice items are often confusing to students and emphasize the wrong answers.

Teaching in the stem. The test item's purpose is to appraise the student's knowledge, not cater to it. Teaching gives away too many clues as to the correct response and deflects from the examinee's critical thinking abilities.

Opinionated items. Stems should present objective facts to be tested, not evaluate subjective opinions.

References

Ncsbn learning extension. (2007). Test development and item writing (v3.0). Available: NCSBN Learning Extension