Abstract
BACKGROUND: Rapid expansion of higher education and graduation rate in Ethiopia, doesn't tell much about quality of core processes like teaching and learning. Despite the fact that preparation of a good item is essential, little attention has been paid to examining characteristics of exam items such as difficulty, discrimination, and distractor efficiency. Unless these characters are examined results may lead to biased evaluation. To address the current issue, this study aimed to carry out item analysis of multiple choice questions (MCQs) in undergraduate health sciences students of Mekelle University, Tigray, Ethiopia in order to evaluate correlations between item difficulty, item discrimination and distraction efficiency. METHODS: Institution based cross sectional study was conducted from March to April 2020. A total of 189 exam papers with 539 multiple choice items and 2224 distracters were analyzed in terms of difficulty, discrimination, distractor efficiency and internal consistency reliability. SPSS version 25 was used for analysis & findings presented using tables & figures. Pearson's correlation & one-way analysis of variance were used. RESULTS: In this study mean difficulty ranged from 0.57-0.81, and discrimination from 0.27-0.52. Difficulty and discrimination were negatively correlated. Six departments achieved excellent reliability, indicating r>0.9. However, the reliability score of Medicine and Pharmacy departments was poor (r<0.5), suggesting areas for improvement. The remaining two departments exhibited acceptable reliability. More than three fourth of the items had non-functional distractors. CONCLUSIONS: The internal consistency of the exams from six departments demonstrated excellent reliability. However, the exams from the Medicine and Pharmacy departments showed areas for improvement. In order to enhance assessment effectiveness, it's crucial to incorporate items that exhibit both desirable difficulty and high discrimination along with functionally realistic distracters. This approach ensures assessments accuracy.