AMIA 2020 Virtual Clinical Informatics Conference – Presenters’ Multiple Choice Questions

Why AMIA is requesting MCQs

AMIA will offer the live AMIA 2020 Virtual Clinical informatics Conference as an on-demand online “enduring” material certified for continuing education credit. A required component of certified education is a brief self-assessment. Typically, that means a quiz of multiple choice questions (MCQs) with explanations and references.

The Clinical Informatics Conference has become AMIA’s “doing” conference, where presenters share the applications of clinical informatics they used and measured, and where participants learn about new informatics tools and approaches they can adopt to help solve similar problems in their own practice settings.

Therefore, your MCQs should challenge your learner less on the facts of your own presentation (eg, the N, or percent of responders), but ideally about underlying theory or using a brief scenario in which you ask the learner to select the next step. Your MCQs allow attendees to reflect on what they learned in your session, receive meaningful feedback, and look up at least one reference per question for evidence.

When are my MCQs due?
9 AM EDT, Monday, May 4, 2020

How many MCQs do I need to write?

  • Workshops: 3 MCQs minimum
  • Panels: 2 MCQs minimum
  • Presenters (15 – 30 minute session): 1 MCQ minimum; more if you like
  • Ignite-style session: 1 MCQ per presenter
  • Poster presenters: none required

How can I write a strong MCQ?

Please work on the MCQs with your colleagues and edit before AMIA’s MCQ submission deadline of 9 AM EDT, Monday, May 4. Due to the pandemic and the recent decision to move the conference online, we are on a tight deadline. We know you are busy, and appreciate timely submission. After you have submitted the MCQs, our Continuing Professional Development committee will review them and edit where needed. Then AMIA will format the questions for online use.

Step-by-step guidance for writing MCQs – IMPORTANT INFORMATION

1. Identify the key "take home" messages from your presentation. If your question requires recall of specific facts, make sure that they are significant ones that are essential to recall. For some presentations, it may be more appropriate to focus on the context around your research. Eg, if your presentation is about health care professionals’ barriers to EHR adoption, consider posing a question about change management theory in healthcare.

2. Write a brief scenario with background information. Please limit the background information to what is essential to answering the question.

3. Write a lead-in question directing the reader to select the best answer. Common lead-in question formats include:

  • Which of the following is most likely?
  • Which of the following is most appropriate?
  • Which of the following best explains this observation?
  • Avoid negative phrasing (e.g., “Which of the following options is not correct?”)

4. Write four plausible answer options, but only one should clearly be the best answer.

  • Do NOT use the following answer formats, as we will immediately return them to you to rewrite:
    • True/False or Yes/No
    • All of the above/None of the above
    • “K-type” questions (1, 2 & 3 are true; 1 & 3 are true; etc.)

5. Write a brief explanation for why the correct option is the right answer. Tell your session attendee why the other options are incorrect. The goal is to provide your learner with meaningful feedback.

6. Submit at least one reference for further study of your topic, formatted using the new https://pubmed.ncbi.nlm.nih.gov/ citation tool, using NLM style.

7. Submit button is all the way at the bottom of this page.

You will likely find it easiest to write your questions in a text document and then copy/paste the information into the fields below.

If you have questions about writing your MCQs, contact Pesha Rubinstein, Pesha@amia.org by April 30.

Helpful resources to help you write outstanding MCQs:

A health care system wishes to reduce the proportion of patients who are receiving more than one opioid medication. Baseline data shows that 98% of duplicate alerts for opioids are over-ridden by physicians. When asked about the overrides, physicians report that the duplicate alerts are inaccurate as they fire when medications are being renewed. Also, the process for cancelling a duplicate medication is overly cumbersome and disrupts their workflow. Assuming that each of the following options is technologically possible with a comparable work effort, which is the most appropriate next step to reduce use of multiple opioids?

  1. Implement "one-click" order cancellation as part of the current workflow
  2. Place a small red asterisk next to orders that will be inactivated by the end of the order session
  3. Switch the duplicate alert from a modal to a non-modal alert
  4. Turn off all duplicate alerts except for opioid medications
  5. Turn off duplicate alerts altogether but educate clinicians about reducing opioid use

Rationale: The goal of the health system is to reduce the prescribing of more than one opioid medication, yet the cumbersome process for cancelling medications makes it much less likely that they will discontinue such duplicates. Integrating a desired change into the workflow in a way that makes it easy for physicians to "do the right thing" is most likely to produce a direct effect on the rate at which more than one opioid is prescribed. Educational interventions alone are highly unlikely to influence physician behavior. Turning off duplicate alerts will reduce alert fatigue and decrease physician dissatisfaction but is not likely to influence rates of duplicate prescribing. Non-modal alerts would be less disruptive to workflow than modal alerts, placing an asterisk next to an already discontinued order would improve awareness of "true" duplicates and showing duplicate alerts only for opioids would reduce levels of alert fatigue. However, these other options are unlikely to reduce duplicate opioid prescribing as long as the order cancellation process is cumbersome and disrupts physician workflow.

1. A clinic is located near a school for individuals with visual impairments. Approximately 2000 students attend the school and many of the 300 staff members have visual impairments as well. Together these individuals account for 30% of those who visit the clinic. In adapting electronic record systems for individuals with visual impairments, which of the following is incorrect?

  1. Computer displays for the visually impaired should be readable by automated text readers
  2. Flexibility in adjusting font sizes in printed materials is crucial
  3. It is essential to have print educational materials in Braille for any visually impaired patient
  4. The contrast between text and blank space on printed documents can aid readability

This question is problematic because details about the school are not needed to answer the question. Also, the question asks "which of the following is incorrect?", which is framed in a negative fashion.

2. In their 2015 study of computer access workarounds, Koppel and colleagues conducted interviews and observations with which of the following?

  1. Cybersecurity experts
  2. Information technology workers
  3. Medical workers
  4. All of the above
  5. None of the above

Although the study had important findings, the question should focus on the key principles:

  • that clinicians focus on patients, and
  • workarounds are common, often at the expense of security.

The precise groups who were interviewed and citation details are not essential.

Also, "All of the above" and "none of the above" are not acceptable answers.