Writing great answer explanations

When you’re answering a question on an exam, you typically want to know one thing - What’s the answer? Even if you get the answer right, you might want to find out if you got it right for the right reason.

That’s why writing a good answer explanation is so critical - it’s a great opportunity to teach the learner something new in a way that’s likely to really stick.

Now it all starts off with writing a great question that makes the learner apply what they know to a clinical situation.

Here’s an example. Once the learner picks an answer, they might get an explanation like this one.

The first key, is to put yourself in the shoes of a learner and offer a very carefully reasoned main explanation that moves smoothly from the question to the answer using a logical set of steps.

A question written in the style of a patient vignette has specific features, and a good explanation dives into those features, rather than simply restating generalities that can be found in any textbook.

The reason for this is two-fold. First, it makes the information more memorable and easier to remember.

Second, this reflects the reality of how patients and clinical reasoning work in the real-world. For example, in our question - the answer clearly addresses an important change in clinical guidelines where it says: “Previous guidelines have included a step that includes endotracheal intubation and suctioning for infants born through meconium-stained fluid“.The trick is to pull out the key learning points and explain them clearly, using a tone that is professional yet approachable.

If, instead, the answer explanation was just a single line that read, “This patient needs positive pressure ventilation”, then that doesn’t really tell the reader anything except the answer - a good explanation explains why that’s the right answer.

That’s why it’s important to really flesh out the answer with a typical length for the main explanation being about one to two paragraphs.

Now - once the main explanation has been written, it’s important to extract the major takeaway from that question. People love this because it’s a short 1-2 sentence summary of the correct answer that captures the key elements from the main explanation.

You can think of it as a nice little recap. The main explanation and the major takeaway are a great place to include relevant clinical images, tables, or figures as well.

Selecting good images and making sure that they are carefully explained is really critical because they can be very useful tools to promote learning and retention.Next, it’s helpful to offer a short explanation for each wrong answer using relevant information from the question stem.

For example, in this case “Intubation for tracheal suction” is a very enticing wrong answer, and the explanation needs to help correct the common misperception.

Imagine if the answer said simply, “The answer is not intubation for tracheal suction.” This misses the mark in terms of explaining why that’s not the correct answer.

Each wrong answer explanation is a powerful opportunity to teach - a high-quality wrong answer explanation is usually 1-2 sentences in length, long enough to give an explanation, but not so long that it becomes a distraction.

Finally, every well-crafted explanation relies on sources that should be referenced. Whenever possible, these resources should be from primary peer-reviewed literature and should be timely and appropriate.

This offers the learner confidence in the information and provides an opportunity to learn more about the topic. Ideally, it would be a link to online material that can be easily accessed with a PubMed ID (or PMID) or a Digital Object Identifier or DOI.

For example, the reference # here is listed as 26473001. If the reference is for a textbook, it should include the edition and page numbers.

Okay - to recap, a great answer explanation offers a learning opportunity that comes at just the right time - when a student is curious.

It should include details that ties into the question, as well as address wrong answer explanations that dive into possible misconceptions, and have appropriate images and references.