Medical Writer Certified Practice Test

AMWA-MWC exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives

Exam Code: AMWA-MWC
Exam Name: AMWA Medical Writer Certified
Type: Online, proctored exam
Duration: 2.5 hours
Number of Questions: 125 multiple-choice questions
Passing Score: 70% (minimum)

1. Gathering (16% of content)
- Determine purpose of document
- Identify context for document
- Identify target audience
- Assess needs
- Identify knowledge gaps
- Select appropriate output type (eg, publications, regulatory documents, continuing medical education materials, patient education)
- Identify appropriate outlet (eg, target journal, other print media, web)
- Apply effective processes to gather information
- Conduct a literature search (eg, PubMed/ MEDLINE)
- Elicit information from collaborators and stakeholders (eg, interview researchers, statisticians, clinicians, patients, regulators, thought leaders)
- Identify other relevant sources (eg, websites, databases, data outputs, clinical guidelines)
- Identify relevant writing guidelines, instructions, and ethical standards (eg, journal instructions for authors, grant application instructions, regulatory requirements)
- Identify relevant document models and templates
- Identify necessary forms and supporting materials (eg, permission to reprint, disclosures, copyright)

2. Evaluating (19% of content)
- Evaluate collected information with regard to
- content (ie, quality and relevance, level of evidence)
- audience (ie, appropriate and relevant to needs)
- context (ie, credibility of sources and suitability for purpose)
- Perform fact or data check
- Identify inconsistencies in data or other content presented
- Conduct critical review of a draft
- Assess quality of writing (eg, clarity, readability, usability, logic, organization, consistency)
- Provide constructive criticism
- Provide options for solutions
- Craft appropriate queries
- Evaluate representation and description of data
- Recognize ethical considerations with respect to self and others (eg, conflict of interest, disclosure, authorship, plagiarism, duplicate publications)
- Evaluate for completeness, fair balance, and absence of bias
- Determine appropriate levels of editing (eg, proofreading, microediting, macroediting)
- Implement best approach to resolve issues (eg, author disagreements, scope change, unexpected delays)

3. Organizing (19% of content)
- Determine correct organization of a document (eg, IMRAD)
- Identify and prioritize key elements of content
- Structure content to communicate message
- Develop an outline
- Apply templates and guidelines to documents (eg, CONSORT, ICMJE, FDA, ICH, PRISMA, ACCME, HIPAA, health literacy)
- Determine structure of tables and figures to best communicate data
- Determine which references to cite in a document
- Comprehend processes of developing and disseminating documents (eg, news releases, publications, grant and regulatory submissions)
- Design project work plan
- Determine deliverables
- Develop timeline
- Recognize roles, responsibilities, and processes
- Track progress and status of a project
- Determine process for tracking changes and version control
- Recognize and apply appropriate software and technology to use in developing a document

4. Interpreting (19% of content)
- Comprehend relevant medical and scientific content
- Understand terminology
- Understand concepts (eg, cellular and molecular level, organism level, and population level)
- Understand study design (eg, clinical trial, case control, longitudinal study)
- Understand statistical concepts (eg, P value, CI, power)
- Interpret clinical and numerical data
- Derive key messages
- Determine inferences, implications, or clinical relevance
- Synthesize and integrate information
- Revise or repurpose existing content
- Comprehend review processes (eg, peer review, grant review, regulatory review)
- Respond to reviewers’ comments
- Interpret feedback from reviewers
- Determine appropriate responses

5. Presenting (27% of content)
- Present the message logically and coherently (ie, tell the story)
- Retain the intended meaning of source materials or original document
- Communicate scientific content appropriately
- Communicate statistical content appropriately
- Develop clear, concise prose
- Write an abstract (eg, for presentation or publication) or executive summary
- Tailor prose to the audience
- Build logical and science-based arguments
- Apply proper mechanics
- Apply rules of grammar, spelling, and punctuation
- Apply proper word usage (general and medical), correct nomenclature, and nondiscriminatory language
- Construct effective sentences
- Construct effective paragraphs (eg, Topic sentences, transitions, repetition of key terms)
- Apply techniques for cohesion between paragraphs and sections
- Apply principles of proofreading
- Apply basic principles of design and layout (eg, document, slide, poster, web)
- Apply principles of visual presentation of data (eg, tables, figures)
- Write document to adhere to standardized formats, guidelines, instructions, and ethical standards

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Killexams.com exam Questions and Answers
Question: 652
In a grant review, a reviewer comments that the proposed trial�s data monitoring plan lacks detail on interim analyses, requesting a Lan-DeMets alpha-spending function to control Type I error for two interim analyses. How do you revise and respond?
1. Retain the original plan, argue that interim analyses are not planned, and cite simplicity
2. Remove the data monitoring plan, propose ad-hoc analyses, and defer to the data monitoring committee
3. Include a Bonferroni correction for interim analyses, report unadjusted p-values, and note flexibility
4. Add a Lan-DeMets alpha-spending function, specify alpha allocation, and justify its use
Answer: D
Explanation: The reviewer�s request for an alpha-spending function is appropriate for controlling Type I error in interim analyses. The Lan-DeMets method flexibly allocates alpha across analyses, and specifying the allocation (e.g., O�Brien-Fleming boundaries) addresses the comment. Justifying its use ensures clarity. Retaining the original plan, using an inappropriate method (Bonferroni), or removing the plan fails to respond adequately.
Question: 653
A medical writer is interpreting a forest plot from a meta-analysis on statin use and cardiovascular events. The pooled relative risk (RR) is 0.85 (95% CI: 0.78�0.93). Which statement is correct?
1. Statins increase the risk of cardiovascular events by 15%.
2. The result is not significant, as the CI includes values above 1.0.
3. Statins reduce the risk of cardiovascular events by 15%, with statistical significance.
4. The RR indicates a 85% reduction in cardiovascular events.
Answer: C
Explanation: A relative risk of 0.85 indicates a 15% reduction in the risk of cardiovascular events (1 �
0.85 = 0.15). The confidence interval (0.78�0.93) does not include 1.0, confirming statistical significance. An RR of 0.85 does not mean an 85% reduction, and the CI does not include values above 1.0.
Question: 654
A phase III clinical trial reports a hazard ratio (HR) of 0.75 (95% CI: 0.62�0.91, p=0.004) for progression-free survival (PFS) comparing a new oncology drug to placebo. The median PFS is 8.2 months for the drug versus 5.6 months for placebo. Which statement best interprets the clinical significance of these results?
1. The drug reduces the risk of disease progression by 25%, with a statistically significant effect.
2. The drug extends median PFS by 2.6 months, but the effect is not statistically significant.
3. The drug has no clinically meaningful impact due to the narrow confidence interval.
4. The placebo is more effective than the drug in delaying disease progression.
Answer: A
Explanation: The hazard ratio of 0.75 indicates a 25% reduction in the risk of disease progression (1 �
0.75 = 0.25) for the drug compared to placebo. The 95% confidence interval (0.62�0.91) does not cross 1, and the p-value (0.004) is less than 0.05, confirming statistical significance. The median PFS difference of 2.6 months (8.2 � 5.6) supports clinical relevance, though clinical significance also depends on context (e.g., disease severity, patient quality of life). The narrow confidence interval suggests precision, not lack of impact, and the placebo is less effective based on the HR and PFS data.
Question: 655
A medical writer is fact-checking a draft CME module claiming a drug�s benefit persists for 5 years, but the cited trial followed patients for 3 years. How should the writer address this discrepancy?
1. Retain the 5-year claim but note the trial�s duration
2. Revise the claim to reflect the 3-year follow-up
3. Verify the claim with a 5-year extension study
4. Remove the claim to avoid extrapolation
Answer: B
Explanation: Revising the claim to reflect the 3-year follow-up ensures accuracy and avoids misleading learners. Retaining the 5-year claim with a note risks confusion, verifying with an extension study is speculative, and removing the claim eliminates a key point unnecessarily.
Question: 656
You are tasked with organizing a manuscript for a clinical trial on a novel antihypertensive drug. The trial includes pharmacokinetic data, adverse event profiles, and subgroup analyses for patients with renal impairment (creatinine clearance <60 mL/min). According to IMRAD structure, where should the detailed description of the liquid chromatography-mass spectrometry method used for drug concentration analysis be placed?
1. Discussion
2. Introduction
3. Results
4. Methods
Answer: D
Explanation: In the IMRAD (Introduction, Methods, Results, and Discussion) structure, the Methods section is reserved for detailed descriptions of the study design, procedures, and analytical techniques. The liquid chromatography-mass spectrometry method used to measure drug concentrations is a technical aspect of the study�s methodology, making the Methods section the appropriate placement. The Introduction provides background, the Results present findings, and the Discussion interprets those findings.
Question: 657
You are writing a lay summary for a clinical trial targeting patients with limited health literacy. The trial tests a new asthma inhaler, reducing exacerbations by 40% (RR=0.60, 95% CI: 0.45�0.80). Which statement best tailors the prose to this audience?
1. The new inhaler cuts asthma attacks by 40% (RR=0.60).
2. The inhaler lowers the risk of asthma attacks (RR=0.60, p<0.01).
3. Asthma exacerbations decreased by 40% (95% CI: 0.45�0.80) with the inhaler.
4. This inhaler reduces asthma flare-ups by 40%, making breathing easier.
Answer: D
Explanation: For patients with limited health literacy, prose must avoid technical terms (e.g., RR, 95% CI) and use relatable language. The correct choice uses "flare-ups" and "breathing easier" to convey benefit clearly. Other options include statistical jargon or lack context for the patient audience.
Question: 658
You are macroediting a regulatory document with inconsistent reporting of adverse events across sections, potentially confusing regulators. The author is pressed for time and resists extensive revisions. What is the best approach?
1. Accept the inconsistencies, as the author�s time constraints are valid.
2. Harmonize the reporting yourself without consulting the author.
3. Query the author to prioritize harmonizing adverse event reporting, suggesting a streamlined revision plan.
4. Remove the adverse event sections to avoid confusion.
Answer: C
Explanation: Consistent reporting of adverse events is critical in regulatory documents to ensure clarity and compliance with health authority requirements. Querying the author to prioritize harmonization, with a streamlined plan, addresses the issue collaboratively while respecting time constraints. Accepting
inconsistencies risks regulatory rejection, harmonizing without consultation disregards authorship, and removing adverse event sections undermines the document�s purpose. AMWA emphasizes clear and consistent reporting.
Question: 659
A medical writer is preparing a protocol for a cluster-randomized trial on a vaccination program. The primary outcome is infection rate, with an intraclass correlation coefficient (ICC) of 0.05 and an expected effect size of 10%. To achieve 80% power at a = 0.05, the design effect is 1.5. How should the writer adjust the demo size?
1. Multiply the calculated demo size by 1.5
2. Increase the demo size by 50%
3. Divide the calculated demo size by 1.5
4. Use the ICC to adjust the effect size instead
Answer: A
Explanation: In cluster-randomized trials, the design effect (1.5) accounts for clustering (ICC = 0.05), inflating the variance. The demo size for an individually randomized trial must be multiplied by the design effect: n_cluster = n_individual * 1.5. This increases the demo size by 50% to maintain 80% power. Dividing or adjusting the effect size is incorrect.
Question: 660
A phase III clinical trial evaluates a novel monoclonal antibody for metastatic colorectal cancer. The trial reports a hazard ratio (HR) of 0.75 (95% CI: 0.62�0.91, P=0.004) for progression-free survival (PFS). Which statement best interprets this result?
1. The antibody has no significant effect on PFS, as the CI includes 1.0.
2. The antibody increases the risk of disease progression by 25% compared to the control, with statistical significance.
3. The antibody reduces the risk of disease progression by 25% compared to the control, with statistical significance.
4. The P-value indicates a 4% chance that the antibody affects PFS.
Answer: C
Explanation: The hazard ratio of 0.75 indicates a 25% reduction in the risk of disease progression (1 �
0.75 = 0.25) for the treatment group compared to the control. The 95% confidence interval (0.62�0.91) does not include 1.0, confirming statistical significance. The P-value of 0.004 suggests a low probability (0.4%) of observing this result by chance, supporting the conclusion that the result is statistically significant.
Question: 661
In a scenario where a medical writing team is developing a 50-page regulatory dossier, the project manager uses Agile methodology with 2-week sprints. Which deliverables should be prioritized in the first sprint to align with Agile principles?
1. Completing 10 pages of the dossier and finalizing the cover page design
2. Defining the table of contents, drafting key sections, and gathering stakeholder feedback
3. Formatting the entire document and submitting it for regulatory review
4. Writing the conclusion and preparing a slide deck for internal presentation
Answer: B
Explanation: Agile methodology emphasizes iterative progress and early feedback. In the first sprint, defining the table of contents, drafting key sections (e.g., study objectives), and gathering stakeholder feedback align with these principles by establishing structure and validating direction. Completing pages without feedback risks rework, formatting the entire document is premature, and focusing on the conclusion neglects foundational work.
Question: 662
A regulatory reviewer requests clarification on a statement in a dossier: �The drug is well-tolerated, with only 5% of patients reporting adverse events.� The reviewer notes that serious adverse events (SAEs) were not mentioned. The data show 2% of patients experienced SAEs. How should the writer revise the statement?
1. The drug is well-tolerated, with only 5% of patients reporting adverse events, none of which were serious.
2. The drug is well-tolerated, with 5% of patients reporting adverse events, including 2% with serious adverse events.
3. The drug has a high rate of serious adverse events, affecting 2% of patients.
4. The drug�s tolerability is uncertain due to unreported serious adverse events.
Answer: B
Explanation: Including the 2% rate of serious adverse events directly addresses the reviewer�s concern and provides a complete picture of tolerability. Stating no SAEs occurred is inaccurate, and emphasizing only SAEs or uncertainty misrepresents the overall safety profile.
Question: 663
In a journal article, you create a forest plot showing odds ratios (ORs) for adverse events across subgroups. The journal requires a 5-inch width, 4-inch height, and 8 pt font for labels. Your plot is 6 inches wide and uses 10 pt font. The OR for one subgroup is 1.45 (95% CI: 1.12�1.88), calculated using logistic regression with SE = 0.13. Verify the CI using CI = exp(ln(OR) � z * SE). What adjustments are needed?
1. Retain width, reduce font to 8 pt
2. Reduce height to 3 inches, retain font
3. Reduce width to 5 inches, change font to 6 pt
4. Reduce font to 8 pt, reduce width to 5 inches
Answer: D
Explanation: CI calculation: ln(1.45) � 0.371, SE = 0.13, z = 1.96. CI = exp(0.371 � 1.96 * 0.13) = exp(0.371 � 0.2548) = [exp(0.1162), exp(0.6258)] � [1.123, 1.871], matching 1.12�1.88. The CI is
correct. Adjustments: reduce width from 6 to 5 inches and font from 10 pt to 8 pt to meet journal requirements. Reducing height or using 6 pt font violates specifications.
Question: 664
A medical writer is reviewing a protocol for a factorial design trial testing two interventions (A and B) for hypertension. The trial hypothesizes an interaction effect on systolic blood pressure. The ANOVA model includes main effects and an A*B interaction. What should the writer verify in the statistical analysis plan?
1. The main effects are excluded to focus on the interaction
2. The interaction term is prioritized for hypothesis testing
3. The demo size accounts for main effects only
4. The ANOVA assumes equal variances across groups
Answer: B
Explanation: In a factorial design, the interaction effect (A*B) tests whether the combined effect of interventions differs from their individual effects, which is the primary hypothesis here. The writer should verify that the statistical analysis plan prioritizes testing the interaction term. Main effects are included, demo size accounts for interaction effects, and equal variances (homoscedasticity) are assumed but not the primary concern.
Question: 665
You are reviewing a draft CME question �What is the dose of Drug Z for hypertension?� The answer is �10 mg/day,� but the referenced guideline states 5�10 mg/day. How should you revise the question?
1. Remove the question due to inaccuracy
2. Query the author to clarify the dose
3. Correct the answer to �5�10 mg/day�
4. Retain �10 mg/day� as it is within range
Answer: C
Explanation: The guideline�s dose range (5�10 mg/day) is more accurate than the single value (10 mg/day), as CME questions must reflect evidence-based standards. Correcting the answer ensures accuracy and learner clarity. Querying the author is unnecessary for a clear guideline, removing the question is excessive, and retaining �10 mg/day� is imprecise.
Question: 666
A manuscript you are editing includes a figure legend: "Figure 1: Kaplan-Meier curve showing survival probability over 24 months." The curve compares two groups, with a log-rank test p-value of 0.008. Which revision improves logical presentation and scientific communication?
1. Figure 1: Survival probability over 24 months, with a significant difference between groups (p=0.008).
2. Figure 1: Kaplan-Meier curve comparing survival probabilities of two groups over 24 months (log- rank p=0.008).
3. Figure 1: Kaplan-Meier plot of survival over 24 months, showing a statistically significant difference (log-rank p=0.008).
4. Figure 1: Survival curves for two groups over 24 months, with a log-rank test result of p=0.008.
Answer: B
Explanation: The legend must be concise, specify the figure type (Kaplan-Meier curve), clarify the comparison, and include the statistical result. The correct choice achieves this by naming the test (log- rank) and p-value, ensuring clarity for a scientific audience. Other options either lack specificity (e.g., "plot" vs. "curve") or are overly verbose, reducing coherence.
Question: 667
A peer reviewer comments: �The discussion does not address the study�s limitations.� The study is a single-arm trial with no control group. How should the medical writer revise the discussion?
1. A limitation is the lack of a control group, which prevents direct comparison to standard care.
2. The single-arm design is a strength, as it simplifies data analysis.
3. The study�s limitations are minimal due to its clear results.
4. The absence of a control group is irrelevant to the study�s objectives.
Answer: A
Explanation: A single-arm trial lacks a control group, limiting the ability to compare outcomes to standard care or placebo, which is a key limitation. Claiming the design as a strength, minimizing limitations, or dismissing the issue does not address the reviewer�s concern or reflect standard scientific practice.
Question: 668
A regulatory reviewer of a Summary of Safety and Clinical Performance (SSCP) for a Class III medical
device comments that the risk-benefit analysis lacks quantitative data, requesting a risk ratio (RR) for major adverse events (MAEs) comparing the device to a comparator. The device had 15 MAEs in 100 patients, and the comparator had 25 MAEs in 100 patients. How do you revise and respond?
1. Report only the absolute risk reduction, omit RR, and state that quantitative analysis is not required
2. Retain the original analysis, argue that qualitative risk-benefit is sufficient, and cite data limitations
3. Calculate RR (15/100 � 25/100=0.6), report with 95% CI, and discuss clinical implications
4. Calculate a hazard ratio instead of RR, report without CI, and note that MAEs are rare
Answer: C
Explanation: The reviewer�s request for quantitative data is best addressed by calculating the risk ratio (RR=0.6), which compares MAE rates directly. Reporting the 95% CI provides precision, and discussing clinical implications (e.g., reduced risk) strengthens the analysis. Retaining qualitative analysis, omitting RR, or using an inappropriate metric (hazard ratio for non-time-to-event data) fails to meet the reviewer�s requirements.
Question: 669
In a manuscript, you argue that a new biomarker (serum X) predicts cardiovascular events better than C- reactive protein (CRP). Study data show serum X has a hazard ratio (HR) of 2.5 (95% CI: 1.8�3.4) vs. CRP�s HR of 1.6 (95% CI: 1.2�2.1). Which statement builds the strongest science-based argument?
1. Serum X�s higher HR (2.5 vs. 1.6) suggests superior predictive value over CRP.
2. Serum X is a better biomarker because its HR of 2.5 exceeds CRP�s 1.6.
3. Serum X outperforms CRP, with an HR of 2.5 (95% CI: 1.8�3.4) vs. 1.6 (95% CI: 1.2�2.1).
4. The HR of 2.5 for serum X indicates it is more effective than CRP (HR=1.6).
Answer: C
Explanation: A science-based argument requires precise data presentation, including HRs and confidence intervals, to demonstrate statistical robustness. The correct choice provides full statistical details for both biomarkers, allowing readers to assess the evidence. Other options lack confidence intervals, oversimplify the comparison, or use vague terms like "effective" instead of "predictive."
Question: 670
You are writing a patient education video script on chemotherapy side effects for cancer patients. The context includes cultural sensitivities and varying health literacy levels. What is the most critical factor to consider?
1. Adherence to pharmaceutical marketing guidelines
2. Inclusion of technical data for oncologist review
3. Compliance with clinical trial reporting standards
4. Alignment with plain language and cultural competence principles
Answer: D
Explanation: The video must use plain language and cultural competence to ensure accessibility and sensitivity for diverse patients. Marketing guidelines, trial standards, and technical data are irrelevant to patient education in this context.
Question: 671
You are managing a grant review process for a clinical trial funding application. A reviewer notes that the power calculation (80% power, alpha=0.05) assumes a 20% difference in primary endpoint (blood pressure reduction) but lacks justification for the effect size. The reviewer requests a sensitivity analysis for 15% and 25% differences. How do you respond and revise the application?
1. Retain the original 20% effect size, explain that sensitivity analyses are unnecessary, and cite clinical relevance
2. Conduct sensitivity analyses for 15% and 25% effect sizes, update demo size calculations, and justify the 20% effect size with prior study data
3. Remove the power calculation, propose a fixed demo size, and argue that effect size assumptions are speculative
4. Adjust the power to 90%, recalculate demo size for 20% effect size, and omit sensitivity analyses
Answer: B
Explanation: The reviewer�s request for sensitivity analyses is reasonable to assess the robustness of the power calculation across plausible effect sizes (15%, 25%). Conducting these analyses and updating demo size estimates demonstrates thoroughness. Justifying the 20% effect size with prior study data addresses the reviewer�s concern about lack of evidence. Retaining the original calculation without analysis, removing the power calculation, or changing power to 90% without addressing sensitivity ignores the reviewer�s feedback and weakens the application.
Question: 672
You are developing a clinical trial protocol for a new asthma drug. A source reports a 15% improvement in FEV1 (p=0.04) from a phase II trial (n=60). The audience is a research ethics board. How should you evaluate the source�s credibility?
1. Include the source but note the phase II limitations
2. Exclude the source due to the small demo size
3. Include the source without comment, as the p-value is significant
4. Use the source only if a phase III trial is available
Answer: A
Explanation: Phase II trials provide preliminary data (level III evidence), but small demo sizes limit reliability, a factor that must be noted for an ethics board. Including the source with limitations ensures
transparency. Excluding it omits relevant data, while significance does not address limitations. Requiring a phase III trial is impractical for protocol development.
Question: 673
You are leading a project to develop a CME activity. Which deliverables are essential to include in the project work plan to meet ACCME standards?
1. Budget forecast, marketing collateral, and speaker bios
2. Registration system, attendee list, and travel itinerary
3. Venue contract, catering plan, and promotional videos
4. Educational objectives, needs assessment, and evaluation plan
Answer: D
Explanation: ACCME standards for CME activities emphasize educational integrity and outcomes. Essential deliverables include educational objectives (defining learning goals), a needs assessment (justifying the activity�s relevance), and an evaluation plan (measuring impact). These align with ACCME�s focus on evidence-based education. Other options focus on logistics or marketing, which are secondary to educational deliverables.
Question: 674
A medical writer is tracking a project�s progress using Earned Value Management (EVM). The planned value (PV) is $50,000, earned value (EV) is $40,000, and genuine cost (AC) is $45,000. What is the cost performance index (CPI), and what does it indicate?
1. CPI = 0.80, indicating cost overrun
2. CPI = 1.13, indicating cost efficiency
3. CPI = 0.89, indicating cost overrun
4. CPI = 1.25, indicating cost efficiency
Answer: C
Explanation: CPI is calculated as EV / AC = 40,000 / 45,000 = 0.89. A CPI less than 1 indicates a cost overrun, meaning the project is spending more than planned for the work completed. Values above 1 indicate cost efficiency, and 0.80 is incorrect based on the calculation.
Question: 675
A medical writer is gathering information for a regulatory submission and needs to identify relevant forms for adverse event reporting. Which source is most authoritative?
1. Company�s internal SOPs
2. FDA�s MedWatch program
3. ICH E2B guidelines
4. Peer-reviewed journals
Answer: C
Explanation: ICH E2B guidelines provide international standards for electronic adverse event reporting, ensuring regulatory compliance. Company SOPs may not align with global standards. FDA�s MedWatch is US-specific. Journals lack regulatory authority.

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AMWA-MWC Exam

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