Multiple-choice questions (MCQs) are the foundation for certification exams. MCQ writing by students is an evidence-based learning modality; however, studies on this strategy in graduate nursing programs are limited. In this podcast and article, Drs. Patti Griffith and Patricia Pawlow describe the outcomes of their scoping review on students writing MCQ in healthcare professions education. Writing MCQs is a valuable active learning strategy for graduate students who take high-stakes examinations. MCQ quality improves with faculty involvement. Working in small groups increases students' knowledge and positive perception of this strategy, as did exam inclusion of student-generated MCQ.