A topics × cognitive-levels blueprint with weights and item counts — plan the exam's coverage before a single item is written, with a worked 40-item example.
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| Test blueprint — topics × cognitive levels | ||||||
| Set the exam length, weight each topic by importance, then split each topic's items across the cognitive levels before any item is written. Rename levels to your taxonomy if needed. | ||||||
| Source: NBME Item-Writing Guide (test blueprinting) | ||||||
| Source: Wiggins & McTighe, Understanding by Design (backward design: define the evidence before the activities) | ||||||
| Topic / outcome | Weight (%) | Recall (items) | Application (items) | Analysis (items) | Total items | Notes |
| Topic 1 — e.g. Cardiovascular physiology | 30 | 4 | 6 | 2 | 12 | Emphasise interpretation over recall |
| Topic 2 — e.g. Respiratory physiology | 25 | 4 | 4 | 2 | 10 | |
| Topic 3 — e.g. Renal physiology | 25 | 3 | 5 | 2 | 10 | |
| Topic 4 — e.g. Acid–base balance | 20 | 2 | 4 | 2 | 8 | Pairs well with case vignettes |
| TOTAL | 100 | 13 | 19 | 8 | 40 | Check: weights sum to 100, items to the exam length |
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