Background: Designing an adequately structured MCQ is both complicated and time-consuming. Even after creating appropriately constructed MCQs, item analysis still needs to verify them.
Objectives: The purpose of this study was to assess the progression of students' results across three different consecutive exams following the author's constructed response, using post-exam MCQs item analysis.  Addressing potential exam flaws leads to appropriate action to improve the test standard quality, such as keeping and editing the questions or discarding them.  
Materials and Methods: This cross-sectional descriptive study was conducted on a total of 138 students subjected to three different rotational exams in the Communication Skills course during the academic year 2019-2020. Items were analyzed according to their difficulty index (DIFI), discrimination index (DI), and point biserial correlation values (PBS). Accordingly, action was taken to improve items construction, and students' results were assessed.
Results: The three exams showed a gradual increase in the reliability scores. The mean scores showed a significant progression over time. The distribution of DIFI differed significantly among the three exams.   Better values of PBS and DI were demonstrated in exams B and C compared to exam A.  
Conclusion: Constructed response according toitem analysis is of considerable value in promoting the MCQs standard quality. This is obtained by affirming acceptable DIFI, PBS, and DI indices. The item analysis conducted in this study revealed that communication skills exams showed a considerable rate of acceptable DIFI, PBS, and DI values, particularly in the later tests.