Student-Authored Multiple-Choice Questions: An Innovative Response to Competency-Based Education
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Updated: Jun 5, 2025

Problem-Solving Before Instruction PS-I: A Protocol for Assessment and Intervention in Students with Different Abilities
Published on: September 11, 2021
Background:
The shift to competency-based education inspired reflection on using multiple-choice questions (MCQs) to develop and assess student competency. Student-authored MCQs in other fields demonstrate a higher level of knowledge; however, a gap examining the use of this teaching methodology in nurse practitioner education exists.
Method:
Nurse practitioner students created MCQs addressing content objectives. Faculty reviewed each MCQ's accuracy; students integrated feedback and revised questions. Finalized MCQs were posted in a question bank for examination preparation.
Results:
The question bank contained 112 questions covering 32 topics. Students demonstrated increasing success on these questions in subsequent examinations. Questions sometimes revealed content misunderstanding, which faculty addressed and clarified. Student surveys revealed interest in assignment integration in all courses.
Conclusion:
This assignment has progressed to a group project, and a competency-based rubric, mapped to the level 2 American Association of Colleges of Nursing's The Essentials: Core Competencies for Professional Nursing Education, was added. Using student-authored MCQs is a novel method to develop "knows how" competencies. [J Nurs Educ. 2025;64(7):e85-e88.].
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