Abstract
Background and Aims:
Assessment is an educational process that measures student ability to accomplish specific objectives, helping to bridge the gap between teaching and learning. This study evaluated the quality of multiple-choice questions (MCQs) used to assess undergraduate medical students’ knowledge in the Nutrition & Metabolism course at Taibah University.

Methods:
The study used item analysis to evaluate the MCQs, including item difficulty, item discrimination, reliability, standard error of measurement, and distractor analysis. The study enrolled 171 undergraduate medical students who took a 30-item MCQ exam.

Results:
The results showed that the exam was reliable and consistent in measuring students’ knowledge and understanding, but some items had issues that needed revision or deletion from the question bank. The report provides useful information for improving the exam’s quality and highlights the importance of ongoing assessment and revision of exam items. The findings suggest that ongoing assessment and revision of exam items are crucial to improving the quality of assessments and creating more effective measures of student learning.

Conclusions:
By leveraging these results, educators can identify areas where students may need further support and improve the design of their assessments.

Key words: MCQs, Validity, Reliability, Items analysis.