How to create a board review question

# How to Build a Question
- Read and understand the tested material to grasp basic principles, diagnostic approach, management and therapeutics according to the BOARD level.
- Get familiar with the format, content and high Yield material. Take many exams using Q-banks, the NBME website ] and the actual exam, when ready!.  Respect Copy Rights sources from Q-banks.
- Select a specific content
- Use WikiDoc to obtain information, pictures, videos, and links on the explanations.
- Challenge the test taker: do not give away the correct answer.  Avoid using proper or specific signs. Describe signs and symptoms in lay terms to give the hints. Example:  instead of marfanoid appearance, describe the patient with long extremities, skinny appearance and tall.
- Do not ask negatively i.e. "which of the following is incorrect, not correct or false?".
- Long stems help recreate the challenge on test date. Short and moderate stems test specific facts.

# Multi-step or Jump Question
Include 2 or 3 Jump questions in order to test the medical thinking process, not just the content.  Follow these steps:
- Select one box with a specific topic (i.e. clinical presentation) from the diagram shown below.  Use facts such as:  the clinical presentation (symptoms and signs), the physical exam findings, specific test findings (i.e. labs, imaging, biopsy), the definitive diagnosis, the treatment of choice, its mechanism of action and the most common adverse effect associated with that medication.
- Describe the first box (i.e. typical clinical presentation) in the question stem.
- Ask a specific fact about another box (i.e. what is the mechanism of action of the treatment of choice?).  If possible, revert the order and add extra steps.
- You just created a jump question!

## Example
Microbiology questions require the reader to make the diagnosis, identify the treatment of choice and to know the mechanism of action (3 steps). 
An equally difficult but less elegant question could ask what HLA-subtype is associated with a rheumatological disease.

# Steps to Upload a Question
- Go to the home page on WikiDoc, and click on the icon that says, "Board Review", or click here.
- Click on the big green icon that says "add a board review question".
- Type in your name in the Author Box.
- Select the Exam Type.
- Categories for the question will appear; check off ONE main category, and the appropriate subcategory.
- Introduce an Overall Explanation into the Box focusing on the correct answer choice.
- Use the remaining boxes to type in the answers to the questions and each answer choice explanation.
- You can add an image, if possible.
- Click save page if you're done, or show preview if you like to see how your question will look like.
- Make sure you click save page before you move on!
- Self quality check your work using the WBR quality checklist
- Contact via email the WBR Editors in Chief and WBR Team Members to review your question
- CONGRATULATIONS! You just created a high quality WBR Question!

# Question Design

## Question Stem
- The questions are preferred to be narrated as a clinical vignette, which is not an actual case.
- The information and illustrations should be the testing point
- Below are some of the key points that can be found in a question. They should be orderly included as follows:
Age, Gender (e.g., a 70 year-old man)
Site of Care (e.g., comes to the emergency department)
Duration (e.g. that has started one week ago)
Significant patient history
Significant family history
Significant diagnostic studies or the results of diagnostic studies
Try as much as possible to include images whether still or motion
Initial treatment and response
- Age, Gender (e.g., a 70 year-old man)
- Site of Care (e.g., comes to the emergency department)
- Duration (e.g. that has started one week ago)
- Significant patient history
- Significant family history
- Significant diagnostic studies or the results of diagnostic studies
Try as much as possible to include images whether still or motion
- Try as much as possible to include images whether still or motion
- Initial treatment and response
- The questions should not include negative phrasing, such as except or not

## Answer Choices
- Answers should include five choices,  with one correct answer and the remaining answers are distractors.
- Answers should not be "true" or "false".
- All distractors should be homogeneous, as they should fall in the same category as the correct answer and should be similar in length.
- Long correct answers are discouraged.
- Illogical answers, absolute terms, word repeats (for example: a word or phrase in the correct answer choice, is the same as in the stem) are discouraged.
- None of the above, All of the above or some combination of response must not be used.

## Answer Explanations
- These questions are intended to teach using sources such as:  graphics, references and guidelines if applicable.

### Overall Explanation
- Only ONE answer is the best or the most appropriate one
- Justify why that choice is correct:  explain the pertinent positive findings, not just list the tested subject. (i.e.  the patient has this symptom which is a typical presentation of this disease). Explain also the pertinent negatives.
- Educational Objectives:  include short high yield facts (1 or 2 take-home sentences/phrases).

### Answer Choice Explanation
- Include why the correct answer is correct and why each of the distractors are incorrect.
- Include concise, yet thorough explanation providing a high yield information.
- Add additional information to the correct answer explanation, not explained on the overall explanation.