A multiple choice question (MCQ) is composed of two parts: a stem that identifies the question or problem, and a set of alternatives or possible answers that contain: a key that is the best answer to the question, and a number of distractors that are plausible but incorrect answers to the question. (Centre for Teaching Excellence, University of Waterloo, 2012) Research shows that MCQs are an appropriate competency test for measuring knowledge and comprehension, and can be designed to measure application and analysis. Well-constructed MCQs are also capable of testing the higher levels of cognitive reasoning and can efficiently discriminate between high- and low-achieving students (Abdulghani et al., 2015). However, MCQs are only effective if they are well-designed. Some design principles for MCQs are outlined below. Designing stems Express the full problem in the stem When creating the item, ask yourself if the students would be able to answer the question without lookin...