A Guide for Writing Single Best Answer Questions to Assess Higher-Order Thinking Skills Based on Learning Outcomes

The single-best answer (SBA) question is popularly used in medical education assessment. Writing an SBA which assesses higher order thinking skills (HOTS) is daunting for newcomers as it requires familiarity with learning outcomes (LOs). This guide provides steps to create LOs for HOTS, introduces the SBA, its parts and how the parts relate to the LO. It then provides steps to convert the LO into an SBA. Examples from anatomy, emergency medicine and medical education are provided.