Students' Challenge in Answer-changing on Multiple-choice Exams; Doubting the Answer or Not? A Systematic Review


1 Pediatric Nephrologist, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Mashhad University of Medical Sciences, Mashhad, Iran.

3 Ph.D Student, Student Research Committee, Department of Health Education & Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Ph.D, Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.

6 MA of Clinical Psychology, Department of Psychology, Kerman Branch, Islamic Azad University, Kerman, Iran.

7 Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran.


It is generally believed that changing the answer in multiple choice exams is not recommended as it usually changes the correct answer. The aim of this study was to evaluate answer-changing among students on multiple choice examinations and to investigate the advantages and disadvantages of these changes.
Materials and Methods: This systematic review was conducted through a systematic search of electronic resources in English, including Medline (via PubMed), Scopus, Web of Science, Cochrane Library, and EMBASE with no time limit from inception up to December 2020, using the following keywords on their own or in combination: "MCQ", "Multiple choice questions", "Students", "Answer-Changing", "Changing", and "Benefits", "Advantages", "Disadvantages", and "Challenges".
Results: Eleven studies (n = 29.450) satisfied the required conditions to be included in the present research. It was found that changes in the answers were mostly from incorrect to correct. The results demonstrated that in 72% of cases, the students who changed their answers in an MCQ test had their scores increased and in 28% of the cases, the test scores decreased. A qualitative study showed that in general, students prefer not to change the answers and also they do not find it useful. The results of another study showed that 51% of students believed that revising their answers would improve their test scores (P <0.001). Another study found that, once students changed their answers, the MCQ test scores were increased in the High Stake test. Further changes in the answers did not increase the test scores.
Conclusion: Doubting once in each option and changing the answer in MCQ tests is useful and rewarding for students.