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Many researchers have proposed that student misconceptions afford valuable opportunities for learning and should therefore be assiduously addressed by teachers with adequate knowledge of students’ misconceptions (KOSM). Using a U.S. sample of 79 high school teachers and their 2,413 students, we found that teachers’ KOSM became particularly useful when test items included strong misconceptions. Such items appeared to be harder for the general student sample, but easier for the subgroup of students whose teachers possessed KOSM.