Define the learning objective
Focus on one clear idea per question
Write a clear and concise stem
Include all necessary information in the stem
Avoid negative wording when possible
Make all answer choices plausible
Keep answer choices similar in length and style
Ensure only one best answer is correct
Avoid clues in grammar, wording, or formatting
Randomize the position of the correct answer
Use distractors that reflect common mistakes
Avoid overly tricky or ambiguous questions
Keep the difficulty appropriate for the audience
Use simple and precise language
Check for bias and cultural fairness
Review for accuracy and consistency
Test the question before using it
Edit for clarity, relevance, and readability