title: Is that your final answer? Relationship of changed answers to overall performance on a computer-based medical school course examination.
abstract: BACKGROUND
  Whether examinees benefit from the opportunity to change answers to examination questions has been discussed widely.
  
  
  OBJECTIVE
  This study was undertaken to document the impact of answer changing on exam performance on a computer-based course examination in a second-year medical school course.
  
  
  METHODS
  This study analyzed data from a 2 hour, 80-item computer delivered multiple-choice exam administered to 190 students (166 second-year medical students and 24 physician's assistant students).
  
  
  RESULTS
  There was a small but significant net improvement in overall score when answers were changed: one student's score increased by 7 points, 93 increased by 1 to 4 points, and 38 decreased by 1 to 3 points. On average, lower-performing students benefited slightly less than higher-performing students. Students spent more time on questions for which they changed the answers and were more likely to change items that were more difficult.
  
  
  CONCLUSIONS
  Students should not be discouraged from changing answers, especially to difficult questions that require careful consideration, although the net effect is quite small.
authors.affiliation: Office of Consultation and Research in Medical Education, 1204 MEB, University of Iowa College of Medicine, Iowa City, IA 52242, USA. kristi-ferguson@uiowa.edu
authors.forename: Kristi J
authors.initials: KJ
authors.lastname: Ferguson
authors.forename: Clarence D
authors.initials: CD
authors.lastname: Kreiter
authors.forename: Michael W
authors.initials: MW
authors.lastname: Peterson
authors.forename: Jane A
authors.initials: JA
authors.lastname: Rowat
authors.forename: Scott T
authors.initials: ST
authors.lastname: Elliott
mesh_terms: D003194:Computer-Assisted Instruction; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods* / Q000592:standards; D006801:Humans; D007484:Iowa; D010823:Physician Assistants / Q000523:psychology* / Q000592:standards; D013337:Students, Medical / Q000523:psychology*