With bowtie questions, learners must move answer options from each of the three categories into the appropriate place on a chart. Every bowtie question includes a central "condition most likely experiencing," along with two related "actions to take" and two related "parameters to monitor." You can create new questions within an existing Test or Question Bank or directly from the Questions tab.

This question type is not supported on mobile devices for online exams. Exams including this question type must be completed with a screen width of 1024px or larger.

Creating a Bowtie Question

In the Enter question text box, type in your question.

Use the Rich Text Editor to edit the question text.

If the question requires scrolling, you will see a Back to Top arrow above the Save button.
Under Actions to Take, in the Enter text here box, type in an item for each option.

These are the correct answers for this section of the chart.
Click + Add distractor, and add the option in the Enter Text Here box.

You can add up to three distractors.
Under Potential Conditions, in the Enter Text Here box, type in an item.

These are the correct answers for this section of the chart.
Click + Add distractor, and add the option in the Enter Text Here box.

You can add up to three distractors.
Under Parameters to Monitor, in the Enter Text Here box, type in an item for each option.

These are the correct answers for this section of the chart.
Click + Add distractor, and add the option in the Enter Text Here box.

You can add up to three distractors.
From the Options tab, you can
- Change the Points value of the question.
- Choose the Scoring Type from the dropdown.
  - All or Nothing - Learners receive full credit for a correct answer OR no credit for an incorrect answer.
  - 0 / 1 Partial - Learners earn points for correct answers AND no points for incorrect answers.
- Link a Narrative or Case Study to your question. When linked, click Preview to open a preview modal for the narrative / case study.
  
  A narrative is a descriptive passage, special instruction, a table, image, or other information that you can link to one or more questions. When taking an online exam or printed test, narratives are presented to the learner along with the questions they are linked to.
  A case study is a set of one or more tabs with descriptive passages, special instructions, tables, images, or other information that you can link to one or more questions. Case Studies are typically used to mimic information as it would be displayed in a patient’s medical chart. When taking an online exam or printed test, case studies are presented to the learner, along with the questions they are linked to.
From the Metadata tab, you can view or edit metadata tags associated with the question.
From the Feedback & Rationale tab, you can enter
- Instructor Annotations are additional notes that learners will never have access to, regardless of exam settings.
  
  Use the abbreviated Rich Text Editor to format the question text and / or add a resource.
- Rationale refers to the reasoning or justification behind the question's answer. Understanding the rationale behind a question can help clarify its purpose and relevance.
  
  Use the abbreviated Rich Text Editor to format the question text and / or add a resource.
- Advanced Feedback, when toggled on, allows you to enter specific Correct and Incorrect Feedback for each answer option in each section of the bowtie chart.
- Correct Feedback is positive reinforcement of the correct answer.
- Incorrect Feedback can be constructive criticism or additional information that helps clarify why the learner's response is incorrect.
From the Additional Information tab, you can reference an article from our Knowledge Base that is relevant to your task. You do not need to switch between the EchoExam interface and the Knowledge Base.
Optionally, you can click the Desktop icon to preview how the question is displayed for the learner.
When finished, click Save.

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