Purpose
Medical schools across the United States have an ongoing demand for a robust bank of National Board of Medical Examiners (NBME) style multiple choice questions (MCQs) or ‘items’ to evaluate knowledge application. These MCQs are valuable for active learning sessions like flipped classrooms and as highly-preferred practice problems for students preparing for exams.

Methods
We postulated that training medical students in item writing could be an effective strategy to support their development as students and future medical educators while also expanding the school’s question bank. To this end, we created an 'item writing immersive experience,' a fully virtual summer course for third-year medical students interested in medical education careers. The course was designed to leverage peer learning and deliberate practice to provide experiential learning in item writing to these medical students while they were on clinical rotations across the country.

Results
Fourteen students participated and generated 42 new items spanning a variety of topics, which were added to the school’s question bank. After the course, all students reported feeling confident about writing their own NBME-style MCQs. They acknowledged the course's benefit in learning the content, felt more engaged in their educational journey, and reported a better understanding of navigating MCQs.

Conclusion
Item writing offers medical students a unique opportunity to simultaneously deepen their clinical knowledge and develop pedagogical skills. Engaging in this activity helps students develop skills that support their future careers as educators and enhance their institution's educational resources. Additionally, this experience can foster trust and build stronger alliances between students and faculty. The fully virtual format of the course enables participation of the students when they are away for clinical rotations. Further research is needed to identify whether teaching item writing to medical students effects their performance as test takers.