questioning. As a result of this education, I want you to be able to distinguish the difference between first level and second level questions. So here we have John's rash again, and we can talk a little bit more about his rash. If I wanted to write a question and all I wanted to test was what's the most likely diagnosis of this rash, well that's what's called a first level question. We're looking at the skin findings and we're making a diagnosis and they're asking us for a diagnosis and me this looks like slam dunk Lyme disease, secondary Lyme disease. So that's what I think and I'm looking down at my choices and up there it is, secondary Lyme disease. That's a first level question. A second level question goes one level beyond that. It gives you that history. It gives you that visual information. We're seeing John's rash. We think in our head this is slam dunk, secondary Lyme disease, but the question isn't asking us what's the diagnosis. In a second level question it's asking us something like what's the treatment or what blood test would be indicated or something along those lines. We already know as the test writers that the test takers are probably going to know the diagnosis from the photo at a high rate. So we're going to go one level tougher. You have to clinically diagnose it in your head as a test taker and then know what they treat this condition with and that's what the right answer is. So it's a deeper harder applied knowledge kind of question. That's an example of a second level question. Then there's actually something called a third level question and a third level question is really tough to write but also very realistic. These are more commonly found on the applied exam questions because it's real world scenarios and real world scenarios basically are the same thing as non-ideal world scenarios. So a third level question might be one step deeper in testing your applied knowledge. So when you look at this photo and read this story about his history and physical, it's easy to know the diagnosis and it's easy to know that first line treatment of that diagnosis. But now let's say that the first line therapy for some reason is contraindicated. The question may be what would the second line therapy that he should have to manage this condition be? So that's an example of a third level question. It's sort of that next level beyond. It's like two levels beyond making the right diagnosis. Very real world. As you become better question writers, strive to write some high quality second and third level questions.

medical education

test writing

first level questions

second level questions

third level questions