Purpose: To describe an innovative method of developing multiple-choice items for a board certification examination. Summary: The development of appropriate multiple-choice items is definitely more of an art, rather than a science. The comedy workshop format for developing questions for a certification examination is similar to the process used by comedy writers composing scripts for television shows. This group format dramatically diminishes the frustrations faced by an individual question writer attempting to create items. The vast majority of our comedy workshop participants enjoy and prefer the comedy workshop format. It provides an ideal environment in which to teach and blend the talents of inexperienced and experienced question writers. Conclusion: This is a descriptive article, in which we suggest an innovative process in the art of creating multiple-choice items for a high-stakes examination.
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