Is your program considering adding certain item types to your exams? Have you considered making other changes and wondering how to go about it? Are you trying to propose a change to your Board, but unsure how to approach it? If so, this session is for you! After reviewing the research and needs of our program, we decided to switch some of our 4-option multiple choice items to 3-options. In this session, we will lead a discussion about why organizations make item type changes and the aftermath of the decisions. To begin the conversation, we will present our story and share the key factors and evidence we presented to our Board when seeking their approval. We will share the Board’s reaction, note improvements we have seen as a result of our change, and share stakeholders’ reactions. This session will be led by a program leader and a psychometrician. During this session, we will ask the audience to share experiences and ask questions about achieving success with exam changes.