Rationale Writing 101

The National Board of Osteopathic Medical Examiners (NBOME) has created Rationale Writing 101 to provide training for physicians and PhDs on how to write rationales for multiple-choice items. This interactive course includes videos of NBOMEā€™s in-house physicians as well as a responsive assessment activity. This course provides information on why rationales are valuable and how they can be used for multiple purposes and audiences. Completion of Item Writing 101 is recommended as a prerequisite for this course.

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:

  • Understand the definition of a rationale
  • Apply to multiple-choice items
  • Review the benefits of creating rationales
  • Implement best practices effectively
  • Choose appropriate references
  • Understand multiple uses of rationales
  • Identify a well-written rationale
  • Identify a poorly written rationale
  • Demonstrate comprehension of what makes an excellent rationale
  • Recognize common pitfalls