Manual for ESTRO Teachers

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UNION EUROPÉENNE DES MÉDEC INS SPÉC IAL I STES
EUROPEAN UNION OF MEDI CAL SPEC IAL I STS
Association internationale sans but lucratif – International non-profit organisation
AVENUE DE LA COURONNE, 20 7 T +32 2 649 51 64
BE- 1050 BRUSSELS F +32 2 640 37 30
4) The language used should be simple so that the level of reading difficulty is kept low.
a) The stem should not be a test of the examinee’s reading ability. As the language of choice is
often English it should be borne in mind that many apparent everyday phrases, which are
simple to understand for the native English speaker, can be confusing for other speakers of
English.
5) Should test concepts of understanding or data evaluation and should avoid simple tasks such as
recall or pattern recognition.
6) The content of the stem focuses on a central theme or problem, using clear and precise
language, without excessive length which can confuse or distract test takers.
7) As a general principle, the stem should be stated in a POSITIVE form, structured to ask for a
correct answer and not a “wrong” answer.
a) Negative statements are not characteristic of normal thought processes, and consequently
may place the candidate who is attempting to decipher the item at a disadvantage.
b) Negatively posed questions (e.g. “all of the following, except”) are less effective and more
difficult to understand.
c) If considered important to be used in particular situations the negative term (e.g. “not”,
“except”, etc) should be bolded, CAPITALIZED, underlined, etc to make sure that it is
noticed.
8) Specific terms must be avoided (both in the stem and/or distractors):
a) Absolute terms (“all”, “always”, “none”, “never”, etc) since there are very limited situations
where things are absolute or universally true.
b) Relative terms (“may”, “can”, “could”, etc) may be cues for the correct answer.
c) Imprecise terms (“few”, “many”, “sometimes”, “occasionally”, “rarely” “seldom”, etc) are
not uniformly understood.
9) Do not use abbreviations, acronyms, eponyms, etc. without an explanation of the term in simple
understandable language.
a) The question should not become a test of whether the examinee understands the meaning
of the term!
b) There should be a clearly defined lexicon of commonly used abbreviations which will be
universally understood and which are not open to misinterpretation.
10) Sentence structure in the stem should be grammatically accurate and logically related to the
responses. It should present all relevant information to ensure clarity and understanding.
11) Although the multiple choice item format is brief, sufficient information to make an
interpretation, answer the question, or solve a problem must be included.
a) Avoid superfluous information, but be certain that all necessary details are included.
b) Avoid the use of personal pronouns such as "you" which are inappropriate and perhaps
confusing.
12) Each question should be self-contained and not refer directly to another question.
a) It should not be possible to deduce the answer of one question from the information
presented in a previous or subsequent question.
13) Within a European context, questions should not relate to specific national requirements (e.g.
legal regulations for flying or driving licenses.)