Sara Saadat - Pediatric Nephrologist, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Masumeh Noori - Mashhad University of Medical Sciences, Mashhad, Iran.
Amir Hosein Ghazizadeh Hashemi - Associate Professor of Otorhinolaryngology, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Nafiseh Mousavi bazaz - Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
Masoudeh Babakhanian - Ph.D, Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
Anis Montazeri KHadem - MA of Clinical Psychology, Department of Psychology, Kerman Branch, Islamic Azad University, Kerman, Iran.
Hamed Azadi - Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran.

Background 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 February ۲۰۱۹, 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 = ۲۹.۴۵۰) 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 ۷۲% of cases, the students who changed their answers in an MCQ test had their scores increased and in ۲۸% 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 ۵۱% of students believed that revising their answers would improve their test scores (P <۰.۰۰۱). Another study found that, once students changed their answers, the MCQ test scores increased in the High Stakes 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.

Answer-changing Multiple-choice questions, MCQ, Students