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Elsie Item-Writing Academy

Write questions worth answering.

Most faculty were never taught to write exam questions — they were handed a template and a deadline. The Academy fixes that: placement by demonstration, four adaptive tracks at every exam level and discipline, flawed-item drills with triple-checked rewrites, and a completion record you can present for faculty-development documentation.

Start with the 60-second drill Browse the tracks

Unofficial. The Academy is an independent faculty-development resource — not affiliated with the AAMC, NBME, USMLE, LCME, or NRMP, and not a certification or compliance program. It supports faculty-development documentation; it declares nothing about any school.

Placement by demonstration

Show us what you see, not what you say

The Academy does not ask how good you think your questions are. Tell us what you teach, then take the 60-second drill: six flawed items, ten seconds each, one job — name the flaw. Where you land decides your starting track.

Item 1 of 6
60

    Try it now

    Three drills, no account

    This is what Academy practice feels like: a flawed item, your diagnosis, then the correction and a triple-checked rewrite. These three are free; the tracks hold dozens more.

    A 58-year-old man with a history of hypertension presents with sudden-onset tearing chest pain radiating to the back. Blood pressure is 210/120 mm Hg in the right arm and 160/95 mm Hg in the left arm. Which of the following is the most likely diagnosis?

    Flaw: grammatical cueing

    Option E breaks parallel structure — "Is an esophageal rupture" against four noun phrases. A test-wise examinee eliminates it on grammar, not medicine. The fix: make every option the same kind of phrase, so the only way to the answer is content knowledge.

    Rewrite (cold-solve verified): same stem; E. Esophageal rupture. The correct answer is B, aortic dissection — the tearing radiation to the back with an inter-arm pressure gap is the classic picture.

    Which of the following best describes the function of the myelin sheath?

    Flaw: "all of the above"

    "All of the above" lets an examinee who recognizes any two true statements answer without knowing the third — it tests test-taking, not myelin. The fix: replace D with a fourth plausible-but-wrong statement, so every option must be evaluated on content.

    Rewrite (cold-solve verified): D. It is produced by astrocytes in the central nervous system. Correct answer: A — speed of propagation is the defining function; B and C are true statements about its producers, which is exactly why they make good distractors.

    A faculty member sees pooled stats for one of her exam items (84 responses; illustrative data): p-value 0.91, discrimination index −0.18, option pull A 4%, B 3%, C 91% (key), D 2%. What is the correct next step?

    Item-analysis literacy

    A negative discrimination with a very high p-value says the strongest students are missing an easy item — that smells like a miskey or a subtle flaw. But data never diagnose; they only flag. The rule: negative discrimination = faculty review, never auto-delete or auto-rekey.

    The curriculum

    Four tracks, every level, every discipline

    Tracks run in order — Foundations, then Flaw Clinic, then Distractor Engineering, then item-analysis literacy — and each track teaches at all four exam levels with discipline-specific examples. Every module ends with a completion record you can download from your account page.

    Foundations

    Stem construction, lead-ins, and option sets — the fundamentals at every exam level.

    Flaw Clinic

    The flaw taxonomy: unfocused stems, cueing, two-correct, weak distractors, absolutes — diagnosed and repaired.

    Distractor Engineering

    Distractors that do real work: near-misses, misconception-based options, and data-driven revision.

    Item-Analysis Literacy

    Reading pooled statistics: N, p-value, discrimination, distractor pull — and the review-never-delete rule.

    Student track

    Question-writing as a study technique, routed through Question Studio so every item is cold-solve-checked.

    The film spine

    Twenty teaching films, scripts final

    Each track is paired with short teaching films — one per discipline and per organ system — that walk through flawed-item drills and their rewrites. Scripts and storyboards are final; renders are in production and will appear here when the voice render lands. No placeholder dates, no mock players.

    Anatomy
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Behavioral Science
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Biochemistry
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Biostatistics
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Cardiovascular System
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Endocrine System
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Gastrointestinal System
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Genetics
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Hematology
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Immunology
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Microbiology
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Musculoskeletal System
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Neurologic System
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Pathology
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Pharmacology
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Physiology
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Pulmonary System
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Renal System
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Reproductive System
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.
    Skin
    Script final Render in production
    Item-writing teaching film, 60–90 seconds.

    Completion records

    Proof of the work, in your hands

    Finishing a module records it on your device — module, track, level, and date. Sign in and your account page shows the full record with a one-click download, ready to present for faculty-development documentation. Records live on your device and travel with the standard account export; one-tap delete removes them like everything else.

    What the record is not: it is not a certification, not a compliance statement, and not an endorsement by any accrediting body. It documents that the work was done — nothing more, nothing less.

    For students

    Writing questions is studying

    There is a student track too: drafting your own practice questions is one of the strongest ways to learn a topic — and every item you write runs through Question Studio's cold-solve check, so you never drill yourself on a wrong key. Read the student tutorial, then open the Studio and start writing.