Select-All-That-Apply Questions: What Are They?
Select-all-that-apply questions, sometimes shortened to SATA, provide a scenario or question stem, followed by several answer choices — often five, six or more — any number of which may be correct. Unlike the usual multiple choice question where you pick the one best answer, SATA questions can have two correct answers, four correct answers or in some cases, almost all of them.
This format will test whether you actually understand something in depth, not whether you can spot, the right answer among distractors. This means that SATA questions have a reputation of being harder even for well-prepared students.
Why SATA Questions Are So Difficult
These kinds of questions tend to be more stressful than your run-of-the-mill multiple-choice reasons.
- No partial credit – most scoring systems generally require you to select all the correct options and not select any of the incorrect ones so that you can receive credit for the question.
- Wrong number of correct answers – you do not know how many answers are correct so it is easy to go over or under board depending on the level of uncertainty.
- Similar sounding distractors – SATA questions tend to have a few options that sound reasonable, making it more difficult to confidently eliminate the wrong choices.
- More time pressure — careful evaluation of multiple options takes longer than just picking one answer from a shorter list.
A SATA-type Questions Process
Rather than approaching each option in a random manner, approach every SATA question you encounter in a methodical, consistent way.
- Step 1. Read the question stem carefully. Before you look at the answer choices, be sure you understand exactly what is being asked; misreading the stem can sabotage your entire approach to the question.
- Step 2: Treat each choice as a true or false statement. Rather than comparing options to each other as you might in a standard multiple choice, think of each option in isolation and decide whether it is true or false based on the scenario.
- Step 3: Eliminate the answer choices you know are wrong first. By eliminating the wrong answers, you make the question easier overall, and you can concentrate the rest of the attention on the less certain answers.
- Step 4: Watch for absolute language in all the choices. The incorrect choices often contain words such as “always,” “never,” or “all patients.” Clinical scenarios are rarely that absolute.
- Step 5: Assess the clinical plausibility of each remaining possibility. Ask yourself if each statement would really apply to the specific patient or situation described, rather than just being a fact about nursing.
- Step 6: Do not believe there is a “right” number of correct answers. Beware the misconception that a question "should" have two or three correct options – some SATA questions may have only one correct answer, while others may have several.
- Step 7: Review your choices as a whole before committing. Look at all your selections together - does each one really make sense when the situation, not just on its own.
Common Student Errors on SATA Questions
- Selecting too many options that appear to be true in general, but without carefully considering if they are true specifically for the situation described.
- Under-selection due to uncertainty. Hesitation, not confident in ruling things in or out.
- Speeding through the options, taking the whole list as one big skim and not thinking carefully about the options on their own.
- That a certain number of answers are correct, rather than considering each answer on its own clinical merit.
- Distracting yourself by long or complicated answer choices, thinking that a more detailed option must be more likely correct without checking its actual accuracy.
How to Effectively Practice SATA Questions
- Look for practice questions specific to SATA, since this format requires different practice than standard multiple-choice review.
- Practice explaining why each answer is right or wrong. The trick is to reinforce the rationality of the answer(s) rather than just memorizing the answer.
- SATA questions generally require more careful reading and evaluation than other standard multiple-choice items, so be sure to time yourself during practice.
- Go over any missed SATA questions more closely, noting whether your error was over-selecting, under-selecting, or not grasping a particular choice.
- Group practice by content area, to reinforce the SATA strategy itself and the underlying clinical content at the same time.
Getting Used to This Format over Time
As with any specific question type, success with SATA questions generally requires repeated, deliberate practice, not a single strategic insight. The more you run through scenarios with this same process of consideration, the more you are able to confidently evaluate each option on its own merits and not be overwhelmed by the format.
It is also important to remember that SATA questions test the same basic level of clinical knowledge as other question formats – the format is just another way of testing the same depth of understanding. A solid content knowledge with a consistent strategy will take you through this format as easily as any other.
Concluding Thoughts
Select all that apply questions might seem uniquely intimidating but breaking them, down into a systematic evaluation process you can always use makes them much more manageable than they seem. Treat each option as an independent true/false statement. Watch for absolute language. Practice this format specifically, along with your general content review. This will allow you to approach SATA questions with the same confidence you have with standard multiple-choice items. Through deliberate practice, a format that once intimidated you can now be just another tool to display your clinical knowledge that you have worked hard to build throughout your nursing education.
