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The Impact of Changing Answers on Assessment Performance in a Doctoral-Level Anatomy Class
Mark Wilhelm1,2,3,4,5,6, Dominique Reynolds1,2,3,4,5,6, Craig Wassinger1,2,3,4,5,6
1Mark Wilhelm is the Associate Professor, Admissions Coordinator, Hybrid DPT Program at the Medical University of South Carolina, 151-A Rutledge Ave., Charleston, SC 29425 (wilhelmm@musc.edu). Please address all correspondence to Mark Wilhelm.
Students frequently change answers on computer-based anatomy exams, and changing answers generally improves scores by 5%. This suggests educators should encourage reconsidering responses rather than discouraging answer changes to benefit student performance.
Area of Science:
- Medical Education
- Health Professions Education
- Anatomy Education
Background:
- Optimal performance on multiple-choice examinations is crucial for students, particularly in high-stakes assessments like the National Physical Therapy Examination.
- A common misconception among faculty and students is that changing initial answers on multiple-choice tests is detrimental.
- This study addresses the need for updated research on answer-changing behaviors in health professions education, moving beyond older studies on paper-based exams.
Purpose of the Study:
- To investigate the frequency and impact of answer changes among physical therapy students during computer-based anatomy examinations.
- To determine if changing answers on multiple-choice exams affects student performance.
- To challenge the prevailing misconception that answer changes are generally disadvantageous.
Main Methods:
- A retrospective cohort study involving 174 first-year hybrid Doctor of Physical Therapy students.
- Analysis of 4 computer-based multiple-choice anatomy examinations using ExamSoft data.
- Categorization of answer changes into 7 patterns using MATLAB, with scores calculated both with and without changes.
Main Results:
- Approximately 11.3% of all answered items involved an answer change, with 94.07% of students changing at least one answer.
- The most frequent change was from an incorrect to a correct answer (52.41% of changes), while changes from correct to incorrect were less common (12.8%).
- Examination scores were, on average, 5% higher when answer changes were permitted. Lower-performing students showed greater overall benefit from changing answers, while higher-performing students benefited more per question changed.
Conclusions:
- Answer changing is a frequent behavior in computer-based anatomy examinations and generally leads to improved student performance.
- While some answer changes can be detrimental, beneficial changes occur significantly more often.
- Discouraging answer changes may negatively impact student outcomes; educators should encourage informed reconsideration of responses during testing.
