Item analysis of type “A” multiple choice questions of biochemistry in GIM module, year 1 MBBS program

Background: Medical education is continually evolving to meet the demands of healthcare and scientific advancements. The Defence Services Medical Academy (DSMA) in Myanmar implemented an outcome-based curriculum in 2017. The genetics, immunology, and molecular medicine (GIM) module is a critical component of the first-year MBBS program, laying the foundation for knowledge in biochemistry and related sciences. Methods: This study analyzed the quality of type “A” multiple choice questions (MCQs)- 28 items from the Biochemistry section of the GIM module’s end-module assessment. The evaluation focused on four key indices: difficulty index (P), discrimination index (D), distractor efficiency (DE), and Kuder-Richardson formula 20 (KR-20) for reliability. Results: Of the 28 items, 21 (75%) were classified as having average difficulty, while 5 (18%) were deemed too difficult. Regarding discrimination, 12 (43%) items displayed very good discrimination, while 8 (29%) had poor discrimination, indicating the need for revision. Nearly 70% of the MCQs had fully functional distractors. Overall, the Biochemistry questions showed moderate reliability (KR-20 score =0.682), with three items (11%) recommended for rejection due to poor performance. Conclusions: These findings highlight the necessity of regular item analysis and revision to ensure the quality and fairness of assessments. Faculty development and active learning strategies are essential to improving the overall reliability and effectiveness of MCQs in medical education.