Reducing the Number of Distractors in Multiple-Choice Questions: A Randomized Study in Undergraduate Medical Education.

We observed a higher proportion of items with only two distractors being left unanswered by more than 10% of students; however, this difference did not reach statistical significance (p = 0.067).

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In multivariate analysis ( Table 3 ), none of the included variables emerged as independent predictors, although both showed a trend toward statistical significance.

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