Changing Answers in Multiple-Choice Exam Questions: Patterns of TOP-Tier Versus BOTTOM-Tier Students in Podiatric Medical School

Grant Yonemoto; Milad Kashani; Erica B Benoit; Jeffrey J Weiss; Peter Barbosa

doi:10.1177/23821205231179312

Changing Answers in Multiple-Choice Exam Questions: Patterns of TOP-Tier Versus BOTTOM-Tier Students in Podiatric Medical School

J Med Educ Curric Dev. 2023 Jun 2:10:23821205231179312. doi: 10.1177/23821205231179312. eCollection 2023 Jan-Dec.

Authors

Grant Yonemoto¹, Milad Kashani², Erica B Benoit³, Jeffrey J Weiss⁴, Peter Barbosa⁵

Affiliations

¹ Yale Podiatric Medicine and Surgical Residency Program, Yale New Haven Health, New Haven, CT, USA.
² Swedish Medical Center, Seattle, WA, USA.
³ School of Health and Sciences, Universidad del Sagrado Corazon, San Juan, PR.
⁴ Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁵ American University of the Caribbean School of Medicine, Cupecoy, Sint Maarten.

Abstract

Objectives: Students often express uncertainty regarding changing their answers on multiple choice tests despite multiple studies quantitatively showing the benefits of changing answers.

Methods: Data was collected from 86 first-year podiatric medical students over one semester for the course of Biochemistry, as shown in electronic testing data collected via ExamSoft's® Snapshot Viewer. Quantitative analysis was performed comparing frequency of changing answers and whether students changed their answers from incorrect-to-correct, correct-to-incorrect, or incorrect-to-incorrect. A correlation analysis was performed to assess the relationship between the frequency of each type of answer change and class rank. Independent-sample t-tests were used to assess differences in the pattern of changing answers amongst the top and bottom performing students in the class.

Results: The correlation between total changes made from correct-to-incorrect per total answer changes and class rank yielded a positive correlation of r = 0.218 (P = .048). There was also a positive correlation of r = 0.502 (P < .000) observed in the number of incorrect-to-incorrect answer changes per total changes made compared to class rank. A negative correlation of r = -0.382 (P < .000) was observed when comparing class rank and the number of changed answers from incorrect-to-correct. While most of the class benefited from changing answers, a significant positive correlation of r = 0.467 (P < .000) for percent ultimately incorrect (regardless of number of changes) and class rank was observed.

Conclusion: Analysis revealed that class rank correlated to likelihood of a positive gain from changing answers. Higher ranking students were more likely to gain points from changing their answer compared to lower ranking. Top students changed answers less frequently and changed answers to an ultimately correct answer more often, while bottom students changed answers from an incorrect answer to another incorrect answer more frequently than top students.

Keywords: BOTTOM-Tier students; TOP-Tier students; assessment; medical education; multiple-choice exam questions.