Assessments
Multiple Choice and Short-Answer
Questions
Updates
 Updating templates for HIT cert/program approval and
dissemination; will send out on Wednesday
 Created templates for scenarios and other learning activities;
will send those out this afternoon
Topics
 Comparison of different types of multiple choice and short-
answer questions
 Incorporation of mini-scenarios into assessments
 The right assessment questions for the desired learning
outcomes
Example #1: Multiple choice
a. Which organization
began with a focus on
management engineering?
a) AMIA
b) HIMSS
c) AHIMA
d) NAHIT
e) JHITA
b. Studies have identified
which of the following as a
way to reduce medical
error?
a. reduce reliance on
memory
b. improve access to
information so that
decisions aren’t made
based on incomplete data.
c. avoid hand-written orders
d. all of the above.*
Example #2: Short answer question
 a. What is the definition of
a hospitalist?
 b. How has the role of
hospitalist affected
physician-patient
interaction in hospitals?
Multiple choice meets scenario
BEFORE:
 Which of the following is the most secure way to carry sensitive
data?
A. On a laptop
B. On a USB drive chained to your wrist
C. On a CD titled “The Chipmunks Sing Disco Duck”
 Feedback for incorrect answer: Incorrect.Try again.
From Cathy Moore’s site http://blog.cathy-moore.com/
Multiple choice meets scenario
AFTER:
 Bob wants to work on the salary data at home. He has a long commute on a train. How
should he carry the data with him?
A. On his laptop
B. On a USB drive chained to his wrist
C. On a CD titled “The Chipmunks Sing Disco Duck”
 Feedback for A: Bob falls asleep during the commute, and a thief steals his laptop and sells the data.
Try again.
Feedback for B: Bob falls asleep during the commute. A thief sits next to him, plugs his USB drive
into his laptop while Bob is unconscious, and later sells the data.Try again.
Feedback for C: Bob falls asleep during the commute, and a thief steals all his belongings.The thief
breaks the CD into pieces in disgust and no one ever sees the data.This is the best choice.
Short-answer question meets scenario
1. Since you work in healthcare, your grandmother has asked
you to help her decide if your grandfather, who is terminally
ill, should go to a nursing home, or to hospice, or just stay at
home and have home health services take care of him. How
will you respond to her? In your response, cite differences
among the services provided and your selection rationale.
 In response to this question, you should describe the differences between
these services, the purpose they serve and their scope of service.

Feedback
 Nursing home: may provide skilled care which requires the credentials of a registered
nurse on an around-the-clock basis. It may also provide an intermediate level of care that
provides care primarily reliant on the capabilities of the licensed practical nurse. This
care may include medication administration, ambulating, checking vital signs, and other
nursing and supportive duties.
 Hospice programs provide supportive services to persons who are dying and whose
doctors have determined that their expected life span is 6 months or less. In the hospice
program, the patient agrees to forego major medical interventions for the terminal
illness, is kept comfortable and pain-free to the extent possible, and the patient and
family are supported by the hospice team as they face the death of the family member.
 Home health services are those that are provided in the home of the patient. These may
involve visits by registered nurses, licensed practical nurses, nurse aides, or other
supportive personnel. A limited level of physician therapy may be provided, and if the
patient needs oxygen or medical devices that can be administered in the home, these will
be provided based upon a doctor’s order.
 For the terminally ill patient, home health services may provide adequate care in the
early stages of the terminal diagnosis. However as the patient’s condition progresses, the
family may find that hospice services are needed if the grandfather determines that he
does not want any “heroic measures” taken to extend his life. If he cannot be supported
at home adequately, he may be admitted to a nursing home and be cared for by the staff
there as well as hospice workers
Short-answer question meets scenario
 You’ve seen a blog post by a physician who thinks that the
benefits of EHRs are overrated and that they’re too costly. He
also says that he didn’t become a doctor in order to spend
half his time typing at a computer. Convince him of the
current and future benefits of healthcare providers adopting
EHR systems.
Choosing the right assessment
item and feedback for the
desired learning outcome
Example #1: Training for sales team
Carla, a sales person, is meeting with Amit, a new customer.
She shows him a megawidget.
 “You’ll love this megawidget,” Carla says.
 “I don’t want a megawidget,” Amit says. “I came in here for a
microwidget.”
What is this an example of?
a. Product Boundary Issues
b. Customer Misvetting
c. Courageous Upselling
Example #2: Training for sales team
Carla, a sales person, is meeting with Amit, a new customer.
“I might be interested in your J-12 microwidget,” Amit says. “At
79 wigabits, it has enough power for paramatizing. But I’ve read
that it runs hot.”
What should Carla say?
a. “Are you referring to the Widget World review?”
b. “Actually, the J-12 has only 60 wigabits. I think you’d need
the K-77.”
c. “Our studies have never shown any heat issues with the J-12.
Would you like to see the test results?”
Feedback options
 Let’s say the learner chooses an incorrect option C above—they think Carla should tell
Amit, “Our studies have never shown any heat issues with the J-12. Would you like to see
the test results?”
Feedback option #1
Incorrect. Try again.
Feedback option #2
 While this response won’t derail the sales conversation, it could make Carla seem
defensive and possibly increase Amit’s skepticism. It would be better for Carla to show
that she’s familiar with what the industry is saying about our widgets. Try again.
Feedback option #3
 “I’m not surprised that your studies don’t show any problems,” Amit says, sounding a
little annoyed. “But Widget World does rigorous, independent testing, and they found
heat issues. What can you say about their results?”
Different angle on assessment
1. Create a visual representation of the different elements
of care described in Chapter 3, including a brief
description of and one example for each. [Feel free to
create just a basic chart using something such as MS
Word, or explore other mapping tools
http://www.lifehack.org/articles/technology/11-freemind-mapping-applications-web-services.html;
http://www.mindomo.com]
Tips for Writing Effective Questions
 Use clear, precise, simple language
 Do not introduce brand new information in the question
 Include instructions on how to answer question if there
is room for interpretation
 Remove ambiguity
 Tortuous syntax
 Unfamiliar vocabulary
 Double negatives “when should you not reject…?”
Avoid Common Test Mistakes
 Avoid asking absolute questions (all, every, entirely, everybody,
completely, always, never…)
 Vary your pattern
 Ensure that articles or other grammatical elements in the
question don’t point toward the correct answer
Other tips?