Surprisingly few changes were made to the blueprint through the early 1970's. Dr. Hooper's subcommittee, which included Drs. S.E. Strahm, R.R. Shomer, W. Kay and E.R. Ames, came up with a three dimensional blueprint, consisting of organ system, animal species, and discipline categories. The three-dimensional blueprint approved in 1979 would serve as the basis for the NBE, with minor modifications, for the next 20 years. Item Writing Perhaps the most labor intensive step in the development of an examination is item writing.
Good items are the key to a good examination, and good multiple choice items are hard to write.
The item writing process began with the appointment of a group of 25 item writers. The item writers represent a cross section of the profession, with representatives from academia and private practice. Each item writer was asked to write 50 items. The item writers met at the NBME office in Philadelphia in February for an item writing workshop. NBME staff reviewed the characteristics of a good item and pointed out some common flaws with examination items.