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Updated: Aug 16, 2026

A Cross-Disciplinary and Multi-Modal Experimental Design for Studying Near-Real-Time Authentic Examination Experiences
Published on: September 4, 2019
Answering multiple-choice questions in high-stakes medical examinations
Martin R Fischer1, Sibyl Herrmann, Veronika Kopp
1University of Munich Hospital, Clinic for Internal Medicine, Downtown Campus, Munich, Germany. fischer.martin@med.uni-muenchen.de
Objectives:
To examine whether changing initial answers during a multiple-choice question (MCQ) test in medicine brings about better overall test results, as has been shown in other academic fields.
Methods:
A total of 36 answer books from the German Second National Medical Board Examination, with 580 MCQs (where 1 answer out of 5 must be selected), were used for analysis.
Results:
We confirmed that high-stakes MCQ test scores in medicine did indeed improve when students changed their answers once. Further changes of answers did not improve the scores.
Conclusions:
In written, high-stakes medical examinations, we recommend that students be encouraged, after further reflection, to change their answers in MCQ tests for questions for which they had previously had doubts about the answers.
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