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Studying for ABEM

Multiple Choice Exams

Mary Jo Wagner, MD, FACEPChief Editor, PEER VI, VII, VIII, IXEditor-in-Chief Emeritus, PEER

Professor, Emergency MedicineChief Academic Officer/DIOCMU Medical Education Partners

Disclosures

I have received

compensation for my

work as the Editor of the

PEER Boards review

products from ACEP.

What about the Test?

“What every EP needs to know”

• Content from major texts, clinical practice & national standards

• No tricks or traps

• Pathophysiology on the Qualifying exam

• “Walking around knowledge” for MyEMCert

Topic Relative Weight

What

mistakes do

we make?

• Use the wrong technique for

learning style

• Believing that one can cram

for an ABEM exam

• Using only one studying

technique

• Disregard usefulness of

teaching for learning oneself

Personal Learning Style

VISUAL LEARNER –LOOK AT & READ STUDY

MATERIAL

AUDITORY LEARNER –LISTEN TO LECTURES OR

REVIEW VIDEOS

KINESTHETIC LEARNER –TAKE NOTES WHILE

LISTENING, WRITE ON WIPE BOARD

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Self-Assessment

Honest self-appraisal:1. Take a Pretest2. Identify wrong answers3. Be honest

a. “Just didn’t read the questions carefully”b. Know just enough to fall into designed trapsc. Over-think the questionsd. Clear knowledge gaps

The Utility of Study Strategies

The Utility of Study Strategies

UtilityorEffectiveness

Strategy Comments

High Practicetesting Practicetestingenhanceslearningandretentionincludinguseofflashcards,practicequestionsandpracticetests.

High Spacedreview Spacingstudyepisodesoutwithbreaksinbetweenstudysessionsorrepetitionsofthesamematerial.(20%interval)

High Elaboration Adddetailstoinformationalreadylearnedtohelpwithunderstandingandmemory.

High Self-createdstudyaids

Developyourownstudyaids,whichwillgiveyourbraintheopportunitytomaketheassociationsitwillremember.

Moderate Interleavedpractice

Interleavedpracticemixesorvariespracticeofthevariousconceptstobelearned.

Moderate Self-explanation

Enhanceslearningbysupportingintegrationofnewinformationwithpriorknowledge.

Moderate Associations Createmeaningfullinksbetweennewlyacquiredinformationandexistingknowledgeovertime.

Moderate Cramming Betterthannotstudyingatall,butdoesnotleadtolong-termretention.

Low Summarization Thisisusefulasnote-takingstrategybutwithoutmakingconnections,lesssuccessfulasastudystrategy.

Low Rereading Mostoftheeffectsofrereadingarelinkedtorecall-basedmemorymeasures–thebenefitforcomprehensionisnotclear.

Low Highlighting Highlightingdoeslittletoboostperformance–whentextsaredifficult.Mayhurtperformanceonhigher-leveltasks

Low Mnemonic

Doesnotleadtobetterperformanceondelayedtests.Timespentdevelopingkeywordcouldbeusedforpracticetesting.

Low Other-createdstudyaids

Studyaidscreatedbysomeoneelsedonothelpyoumaketheassociationsneededtorecallandapplyessentialinformation.

Login to PEER IX – https://peerix@acep.org

Sign in with usual ACEP login (email is user name)

Modified from “A Ranking of Learning and Study Strategies.” Created by Eron Drake, Ed.D, Director of

Academic Success, Central Michigan University College of Medicine

References:

Clark, C.M., & Bjork, R.A. (2014). When and why introducing difficulties and errors can enhance instruction. In V.A. Benassi, C.E.

Overson, & C.M. Hakala (Eds.). Applying science of learning in education: Infusing psychological science into the curriculum.

Retrieved from the Society for the Teaching of Psychology website: http://teachpsych.org/ebooks/asle2014/index.php

Dunlosky, J., Rawson, K.A., Marsh, E.J., Nathan, M. J., & Willingham, D. T. (2013). Improving students’ learning with effective

learning techniques: Promising directions form cognitive and educational psychology. Psychological Science in the Public

Interest, 14(1), 4-58. DOI: 10.1177/1529100612453266. Retrieved from

http://psi.sagepub.com/content/14/1/4.full.pdf+html?ijkey=Z10jaVH/60XQM&keytype=ref&siteid=sppsi Sefcik, D. J., Bice, G., & Prerost, F. (2013). How to study for standardized tests. Burlington, MA: Jones & Bartlett Learning.

Practice TestingSpaced Review

Elaboration

Set a schedule

• Interleaved Practice

• Spaced Review

January 2020 This is a blank and printable January Calendar. Downloaded from WinCalendar.com

◄ Dec 2019 January 2020 Feb 2020 ►

Sun Mon Tue Wed Thu Fri Sat

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Cardiology TCA EKG

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Toxicology

EKG Tox

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Endocrine EKG HypoK

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Cardiology Heart failure

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Toxicology Diuretics

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Endocrine Adrenal crisis

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More Calendars from WinCalendar: Feb 2020, Mar 2020, Apr 2020

Created with WinCalendar Calendar Maker for Word & Excel

► For more calendar layouts, colors, options, and for calendars with Religious Holidays download WinCalendar from WinCalendar.com.

► You can even convert Microsoft Outlook, Google Calendar or Yahoo Calendar to Word and Excel format using WinCalendar.

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Self-created Study Aids

Self-explanation

Associations

Cramming

Low Effectiveness

Why Study Test Questions?

Basic approach

• Look at each answer as a true/false question

• Don’t answer the question without looking at each foil

• A long question? – 1st read the phrase with a

question mark

A 55-year-old man with alcoholic cirrhosis of the liver presents with lethargy, confusion, and asterixis. His vital signs are normal. Which of the following medications could worsen his condition ?

A. Diazepam

B. Lactulose

C. Neomycin

D. Thiamine

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Best Practice – MCQs

• Read question & answer

• Read explanation

• Identify how to change the question so each foil would be correct

• Identify common errors or interpretation issues

What pattern describes the most common findings of purpura in a patient with Henoch-Schonlein?

A. Begin over the distal joints and spread centrally

B. Associated with bullae or infarcted areas

C. Occurs in areas of pressure or minor trauma

D. Symmetrically affects the lower extremities

Questions with Visual Stimuli

A 34-year-old primigravid female who is 28 weeks pregnant presents with severe epigastric abdominal pain radiating to the back with multiple episodes of non-bilious, non-bloody emesis over the last 4 hours. The nurse drew her labs and reports an odd chalky consistency to the blood as shown.A. Cholecystitis B. Hyperemesis Gravidarum C. Pancreatitis D. Placental abruption

Typical Errors

• Lack of script

– Recognition

– Specificity

• Anchoring bias

Overthinking

• Under-confidence

• Casual attribution

• Maladaptive solutions

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Secrets of

ABEM Exam

Taking time for

“The Boards”

• Develop a post graduation plan

• Set aside time early to study

• Recognize distractions

Just before your Exam

• No night shifts

• Time off for Boards review

• Eat breakfast

What about the Test?

“What every EP needs to know”

• Practice testing

• Spaced learning and interleaved practice

• Expand each question answer to elaborate

• Confidence and reality of knowledge base

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