Objectives: Behvarz training centres are recognised as primary training centres for community health workers. The aim of this study is to assess the quality of descriptive multiple-choice and essay questions in three cohort of Saqez Behvarz Training Center.
Materials and methods: This descriptive study analysed 2077 multiple-choice questions, 75 essay questions, and 360 multiple-choice questions related to the final exam of three recent courses. The questions were examined for their structure, differentiation and difficulty index, and taxonomy level. The checklist was created and utilised following a review of the texts and agreement among medical education experts. The checklists were found to have an interrater reliability of 90% based on agreement calculations between two evaluators..
Results: When examining the structure of multiple-choice questions, it was found that 82.5% of the test questions had a suitable structure. The main structural flaw was the vertical listing of questions. In terms of the taxonomy used, 65.48% of the multiple-choice questions were designed in Taxonomy I, 23.92% in Taxonomy II, and 10.6% in Taxonomy III.
Conclusion: The questions had an appropriate difficulty index, but the differentiation index was inadequate. The majority of the questions were in the lower cognitive domain. While multiple-choice questions were better designed than essay questions, it is recommended that the questions be reviewed and modified, and that training be provided on the standard design of various student evaluation questions to empower trainers.