Journal of Nursing Education

Letter to the Editor Free

Never Change Answers on Examinations: Evidence-Based Practice in Nursing Education?

John R. Blakeman, BSN

The author has disclosed no potential conflicts of interest, financial or otherwise.

To the Editor:

Many nursing students, and students in general, have probably heard the saying, “Don’t change your answer on a test. Go with your gut instinct.” Some educators seem to endorse this strategy as well, encouraging students to stick with their first answer. Specifically, more than half of the professors in one study believed that changing answers on a test led to lower scores (Benjamin, Cavell, & Shallenberger, 1984). The apparent logic behind this thinking seems to make sense. After all, people are generally taught that first instincts are correct, and they may think that the brain immediately leads them to the correct answer. However, is not changing answers an evidence-based approach, or is it just a sort of folklore that has been passed down from generation to generation?

Indeed, the problem is that this “go with your gut” test-taking strategy is not evidence based, and the sporadic (and generally dated) studies that have been conducted tend to support that changing answers on an examination is actually a beneficial strategy for students. The evidence, although not seemingly widely disseminated or implemented in the classroom, has suggested that when students change answers on a test, they actually tend to end up with a higher score than those who do not change their answers. That’s right—changing an answer may in fact be better than going with the first choice! Interestingly, the first major study to show that changing answers on an examination can be helpful was published more than 80 years ago (Mathews, 1929), but the fear of changing answers still persists today.

Admittedly, the majority of studies on this topic were published prior to 2000. For example, Benjamin et al. (1984) conducted a systematic review of studies researching the effect of changing answers on tests. Their results showed that when the overall means were compared in the 33 studies analyzed, students were not negatively impacted by changing their answers. Their systemic review also indicated that the findings apply to tests of various types and different academic disciplines. Although that review is dated, to the author’s knowledge, no more recent systematic review has been conducted on the topic.

A more recent study revealed that students who were informed that changing answers can be beneficial scored higher on their examinations than students who were not aware of the potential benefit (Bauer, Kopp, & Fischer, 2007).

Such results have been found in nursing as well. For instance, Jordan and Johnson (1990) analyzed 284 examination sheets for evidence of changed answers. They found a significant difference for students who changed their answers from wrong to right, with 55.3% of students gaining points from changing their answers. In addition, less than one in five students lost points because of changing their answers. A more recent nursing study by Nieswiadomy, Arnold, and Garza (2001) found that 93.3% of students (111 total) did not experience a negative effect from changing their answers, and the majority of students actually gained more points by changing their answers.

Anecdotally, students suggest that they are subsequently incorrect when they change their answers. However, what causes this thinking, as it seems the evidence points to the fact that students actually do better when they change their answers? First, when students receive their marked examinations, many may focus on the questions they missed and pay little attention to those they did not miss. If they notice they missed one or more questions on which they changed their answers, it would perhaps convince them that changing the answers was not a good decision and they should not go against their first instinct. This counter-factual thinking may create a level of superstition for future tests, and students may not want to take the risk of changing an answer (Miller & Taylor, 1995). However, do students notice all of the questions on which they changed their answers from wrong to right? It logically follows that when students change their answer, especially more than one, they frequently may not realize their change resulted in a positive outcome if they did not explicitly mark these questions; however, they may recognize when the change has resulted in a negative outcome. Finally, it is important to note that in some cases students may occasionally score worse because they changed their answers, but it does not mean that this outcome will result every time. If students apply the strategy of changing answers test after test, the overall outcome will likely be more positive, according to the research literature (Bauer et al., 2007; Benjamin et al., 1984; Miller & Taylor, 1995; Nieswiadomy et al., 2001).

Kruger, Wirtz, and Miller (2005) suggested that the fallacy of changing answers has persisted largely due to “if only” thinking. In other words, students begin to feel regret for changing answers instead of recognizing positive emotions from changing their answers when the change has led to a positive outcome. When students change an answer and get the question wrong, they may think, “If only I had left my answer the same.”

Although many studies have been conducted in the past, additional studies should be conducted in the nursing discipline to replicate previous work in this area. In addition, more research should focus on computer-based testing because education and technology are advancing, and more examinations seem to be shifting to computerized formats, such as the NCLEX-RN® and NCLEX-PN®. Also, studies need to be able to account for more specific elements during test taking, such as level of confidence when changing an answer. For example, if a student simply marked the wrong answer on an examination and then realized he or she actually meant to select a different option, this change of answers is not really a change that resulted from logical reasoning but rather just realizing there was a mistake in the initial option selected. However, changing an answer when a student has very little inclination as to which answer is correct would present an entirely different scenario. In this case, a change from an “A” to a “D” answer made on a whim and not because of any sound reasoning could potentially result in different findings. However, the literature strongly suggests that students should not be afraid of changing their answers on examinations, as it does not hurt and could in fact result in a higher score (Bauer et al., 2007; Benjamin et al., 1984; Jordan & Johnson, 1990; Krueger et al., 2005; Mathews, 1929; Miller & Taylor, 1995; Nieswiadomy et al., 2001).

The idea that changing an answer can actually benefit students may be a difficult concept for students and faculty to grasp and could explain why it has taken a long time for this test-taking habit to be disseminated in the classroom setting. With the focus on evidence-based practice in nursing and health care, it seems vital to apply this evidence, not only in the clinical setting but also in the educational setting. It is troublesome that this fallacy has been perpetuated for decades when research suggests that changing one’s answers may be helpful. The NCLEX-RN and NCLEX-PN examinations do not allow students to go back and change answers after moving to the next question, but perhaps this practice should also be addressed.

The bottom line is that faculty should not discourage students from changing answers. If anything, faculty should explain to students that changing answers, when there is some rationale for the change, may indeed be helpful.

John R. Blakeman, BSN

Millikin University


  • Bauer, D., Kopp, V. & Fischer, M.R. (2007). Answer changing in multiple choice assessment change that answer when in doubt—and spread the word!BMC Medical Education, 7, 28. doi:10.1186/1472-6920-7-28 [CrossRef]
  • Benjamin, L.T. Jr.. , Cavell, T.A. & Shallenberger, W.R. III.. (1984). Staying with initial answers on objective tests: Is it a myth?Teaching of Psychology, 11, 133–141. doi:10.3928/01484834-20090401-06 [CrossRef]
  • Jordan, L. & Johnson, D. (1990). The relationship between changing answers and performance on multiple-choice nursing examinations. Journal of Nursing Education, 29, 337–340. doi:10.1207/S15328023TOP2901_04 [CrossRef]
  • Kruger, J., Wirtz, D. & Miller, D.T. (2005). Counterfactual thinking and the first instinct fallacy. Journal of Personality and Social Psychology, 88, 725–735. doi:10.1037/0022-3514.88.5.725 [CrossRef]
  • Mathews, C.O. (1929). Erroneous first impressions on objective tests. Journal of Educational Psychology, 20, 280–286. doi:10.1037/h0071721 [CrossRef]
  • Miller, D.T. & Taylor, B.R. (1995). Counterfactual thought, regret, and superstition: How to avoid kicking yourself. In Roese, N.J. & Olson, J.M. (Eds.), What might have been: The social psychology of counterfactual thinking (pp. 305–332). Mahwah, NJ: Lawrence Erlbaum Associates. doi:10.1136/qshc.2008.029066 [CrossRef]
  • Nieswiadomy, R.M., Arnold, W.K. & Garza, C. (2001). Changing answers on multiple-choice examinations taken by baccalaureate nursing students. Journal of Nursing Education, 40, 142–144. doi:10.1177/0894318409353801 [CrossRef]


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