Download 1. Increasing Medical Knowledge

Testing . . . Testing . . .
1,2,3
Nancy F. Barrett EdD
August 25, 2008
Strategies to be Successful Test Takers
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Strong medical knowledge
Good written English skills
Familiarity with the test’s computer process
Attend to logistics before and during exam
Employ test taking strategies by:
a. Looking for medical knowledge clues
b. Looking for wording clues
Employ effective stress reduction strategies
General Characteristics of
ITE, Step 3 and ABFM Exams
Test of overall medical knowledge
 Written by practicing physicians
 Use clinical scenarios
 Both inpatient and outpatient settings
 Heavily oriented towards Adult Medicine
(see 07 Aggregated Results hand out)
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1. Increasing Medical Knowledge
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Review In-Training results and rotation evaluations.
Develop an education plan to address deficits.
Use evidence based resources to read about patient
cases.
Set aside some time each day to read on a case or
specific medical concept.
Use resident presentations to address an area of
interest/need.
Develop a clinical poster or presentation Organize a
study group if you learn well that way
Participate in Board study sessions sponsored by the
residency.
Ask questions of your preceptors!
2. Fluency in written English
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Review old ITE exams and note any terms or
concepts that are problematic.
Review your evaluations and note any
communication issues noted by attendings.
If you have concerns, ask for help.
3. Familiarity with the Computer System
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Use the practice tests provided by USMLE
Review list of sites recommended by other
residents.
Take the time to familiarize yourself with the
system and expectations before the exam!
4. Logistical Issues—BEFORE the Test
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Arrive early at the testing location, preferably the night before
Find the location the day before the test, including where you
will park, where the test center is, where you can eat lunch
Get a good night’s sleep prior to the exam
Restrict fluid intake
Restrict caffeine intake
Use the restroom prior to the start of the test, since you will not
be able to leave.
Identify stress reduction strategies that work for you. (eg:
breathing deeply, closing your eyes for a moment, stretching in
your chair)
Turn off your cel phone
Be familiar with testing guidelines.
4. More Logistics
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Wear comfortable clothing and shoes
Bring a jacket
Dress in layers
If you wear contacts, bring a pair of glasses.
Bring gum or mints, if allowed by the testing
center.
Bring Kleenex and cough drops.
Bring a wrist watch to keep track of time.
4. Getting Started
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Allow yourself a minute to release panic or stress
READ AND FOLLOW THE DIRECTIONS
Preview the test (as possible)
Keep moving-don’t get bogged down on a question
Keep track of time-remember: you have about a minute
per question!
5. Test Taking Strategies-General
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Eliminate obvious wrong answers
Eliminate highly implausible answers
If an answer seems obvious, choose it
Go with your first instinct, unless subsequent
review shows you made an obvious mistake
(your first instinct is usually correct)
5. Test Taking: Medical Clues
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History, especially recent travel
“Magic” words like ethnicity, geography or
occupation. eg: Cambodian origin for rheumatic
heart disease
Epidemiological fit (lupus and young female)
Abnormal findings
XRays, MRI’s or lab results
Medications list and Black Box warnings
When asked for the next step, think emergency!!
6. Test-taking: Clues in Questions
In the question stem:
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Note key words
Devise a response before reading options
Eliminate choices that do not agree grammatically
Examine common wording in stem and alternatives
Not in a question reverses the meaning.
6. Clues in Answers
 Specifically
note words like except and not
 Summarize complex questions
 Select choices that have opposite meanings
 Avoid choices with always or never
 If confused, turn options into true-false statements
 Longest option is likely to be correct
 If two answers are the same except for one or two
words, one of them is probably correct
 If two choices appear correct, choose the one that
causes the other
 Always pick the most inclusive answer
6. Most Likely Correct Responses
When in doubt, choose . . .
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Middle choices (b or c)
Middle numerical value
All of the above, none of the above or two of
the above
Conclusion
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Address medical knowledge
Have a good grasp of written English terms
Be familiar with the computer process
Attend to logistics before and during the exam
Employ test taking skills by:
a.
b.
Looking for medical knowledge clues
Looking for wording clues
6. Use effective relaxation strategies before and
during the test. (will address later)
Sources
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Kelly, K. (1999). Taking the boards? Try these strategies for
success. ACPOnline
www.acponline.org/journals/news/may99/boards.htm
Accessed 1028/05.
Carlisle, K. (1985). Learning how to learn. Training and
Development Journal. March. 75-80.
Long, E. (2000). Conquering test writing anxiety. Toronto:
Irving Publishing.
Ludwig, C. (2004) Preparing for certification: Test-taking
strategies. Medsurg Nursing 13;2 127-8.
Steenburgh, J (2003). Strategies to help pass the internal
medicine boards. ACPOnline
www.acponline.org/journals/news/june03/boards.htm
Accessed 1028/05.
Weinstein, C. and Goetz, E., eds. (1988) Learning and study
strategies. San Diego: Academic Press Inc.