AMC MCQ Exams: Introducing the Concept of Pivot Words
Jun 02, 2024
Writing an exam question is a lot harder than it looks. They need to strike the right balance between not being too easy or too hard, and they also need to discriminate (aka be able to separate out candidates for the purposes of ranking). One of the techniques that MCQ writers sometimes use is called Pivot Words - the concept simply means that changing a couple of crucial words can change the entire meaning of a question.
An example is two questions which focus on atraumatic shoulder pain in an adult - exactly same question, but one has reduced external rotation, and whereas the other has preserved external rotation. Why does this mater?
Those words at the end change the entire meaning of the question, as in adhesive capsulitis external rotation is lost as a hallmark feature, whereas it is preserved in supraspinatus tendinopathy.
This is a crucial piece of examination technique - I would estimate that it is the most predominant reason as to why good candidates who know their medicine fail.
