Fine-Tuned Large Language Models for Generating Multiple-Choice Questions in Anesthesiology: Psychometric Comparison With Faculty-Written Items

Supervised fine-tuned LLMs are capable of generating MCQs with psychometric properties comparable to those written by experienced faculty. Given the limitations and cohort-dependency of psychometric indices, automated item generation should be considered a complement rather than a replacement for manual item writing. Further research with larger item sets and multi-institutional validation is needed to confirm generalizability and optimize integration of LLM-based tools into assessment development.