Item Writing 101: Multiple Choice Items with Realistic Clinical Scenarios

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Quick Overview

Running Time: 40 minutes 
Beginning June 1, 2017, the NBOME will charge $25 for our Item Writing 101 course.
This fee helps defray the cost of providing high-quality continuous professional development tools and assessment education to support osteopathic physicians, medical students, and faculty at colleges of osteopathic medicine and AOA Specialty Certifying Boards. 
For information about NBOME National Faculty or group access to NBOME online programs, please contact the NBOME Department of Continuous Professional Development at


Item Writing 101: Multiple-Choice Items with Realistic Clinical Scenarios

The National Board of Osteopathic Medical Examiners (NBOME) has created this course to provide basic training in writing a realistic clinical scenario and single-best-option multiple choice-item. This interactive course includes videos of NBOME's National Faculty Subject Matter Experts (SMEs) as well as responsive assessment activities throughout. The content of this course places an emphasis on assessing competencies for osteopathic medicine and related health care professions. 

Target Audience

This course is intended for new and experienced item writers who are assessing competencies for osteopathic medicine and related health care professions through multiple-choice items.


Upon completion of this activity, participants will be able to:

  • Distinguish between basic-recall and higher-order item objectives
  • Write a realistic, chronologic clinical scenario
  • Write a focused, positively worded lead-in
  • Write homogeneous, plausible answer options
  • Identify and resolve common test-wise clues and item-design issues