The low PISA results for Indonesia led to the emergence of a minimum competency assessment (MCA) with the PISA framework in 2022. This made it difficult for teachers and students to work on MCA questions due to schools’ lack of learning resources. This study produces REALITAS PISAHealth using the context of a clinical discussion forum that is valid, practical, and has a potential effect on reading literacy. The research design is used as the primary research framework for the type of development research, which has two phases: preliminary and formative evaluation. Data were collected by conducting observations, tests, and document reviews. This study involved 35 middle school students under 15 years of age with various reading literacy abilities. REALITAS PISAHealth developed is valid from its compatibility with the PISA 2022 framework, which is related to daily life problems in understanding discussion texts. Practicality can be seen from the REALITAS PISAHealth, which was easily understood by students and completed well, even though for different reasons. In addition, the developed REALITAS PISAHealth has potential effects based on students’ answers at the field test stage, such as understanding the problem, in reality, changing finding keywords, and using reasoning ability in answering.

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