Investigating first instinct fallacy in cytology education and cytomorphology examination.

Introduction: The specific aims of the study are to assess whether answer changing on a high-stakes cytomorphology examination will lower the cytology examinees' scores and to examine whether there is a difference in the frequency of responses changed between high-, average-, and low-performing cytology learners. The paper also seeks to explore if there is a correlation between outcomes of answer changes (success rates) and cytology learner's levels of performance.

Materials And Methods: The eraser marks and pen cross-outs on the cytology final image examinations from 2019-2023 were reviewed and the number of changes made by the examinees and the frequency to which scores were raised or lowered as a result was recorded. Moreover, the response change patterns and outcomes across low-, medium-, and high-performing cytology learners were further analyzed for possible relationships.

Results: Among the total number of questions where answer(s) were changed (n = 98), close to half (n = 47, 48.0%) of the changes resulted in raising the score, compared with about one-third (n = 34, 34.7%) that lowered it. When the students were classified into academic abilities, there was a significant correlation between the success rates of answers changed across low-, medium-, and higher-performing learners χ (df = 24, n = 24) = 10.24, P < 0.05. Our data also showed the average student group to have the highest "scores raised" to "scores lowered" ratio.

Conclusions: Based on these findings, those cytology examinees who are overly cautious about changing initial responses during a high-stake multiple-choice question BOC test may put themselves at a disadvantage.