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Test-Taking Skills

Margaret M. Wilkins, DO, FACOFP

1

Test-Taking SkillsWritten

Presented by Margaret Wilkins, DO, FACOFPBased upon articles and presentation by Donald J. Sefcik, DO, MS, MBA,FACOFP

Overview

Examination Preparation

• Study Skills

• Q&A

Improving Examination Performance

• Test-Wiseness Skills

• Test-Taking Skills

Improving Examination Scores

• Guessing

• Test Anxiety

Question 1An 80 lb child is sitting on one end of a seesaw. If another 80 lb

child jumps from a high platform onto the other end of the seesaw, what will happen?

A. The first child will stay stationary on the ground

B. The first child will be lifted into the air, but remain seated

C. The seesaw will remain in neutral position

D. The second child will bounce off the seesaw

E. The second child will break their neck

2

Question 2

One horsepower is equivalent to

A. 724 watts

B. 746 watts

C. 768 watts

D. 782 watts

Question 3

What is a component of potential energy?

A. Upward reactive force

B. Energy of movement

C. Newtons and distance

D. Time

E. Gravity’s relationship to mass times its acceleration

Question 4

A well uses what type of simple machines to raise and lower a

bucket?

A. Block

B. Tackle

C. Third-class lever

D. Wedge

E. Wheel and axle

3

MCQ: Typical Question

STEM:

19 yom presents…….

RESPONSES:

A

B

C

D

E

Classic Type A Item

19 yo male – Bloody diarrhea and weight loss

Recent onset

No history travel or picnics

No pets including no turtles

Hemoccult positive stool, negative cultures

What is probable diagnosis?

A) Irritable bowel syndrome

B) Salmonella C) Inflammatory bowel dz

D) Shigella E) Meckel’s diverticulum

Multiple Choice QuestionsType A ItemsStem – Presents the problem or question (read first)

Responses – the keyed answer* & distractors^

* One Correct answer or BEST answer

^ Distractors (4)

i. One choice that is rather obviously incorrect

ii. Two choices that are reasonable

a. peripheral to topic

iii. One choice that is very close to the BEST answer

4

Classic Type A Item

19 yo male – Bloody diarrhea and weight loss

Recent onset

No history travel or picnics

No pets including no turtles

Hemoccult positive stool, negative cultures

What is probable diagnosis?

A) Irritable bowel syndrome

B) Salmonella C) Inflammatory bowel dz

D) Shigella E) Meckel’s diverticulum

Test-Wiseness

A subject’s capacity to score higher on an examination is

based on their test-wiseness, a skill which is independent

of the examinee’s knowledge of the subject matter.

Evans 1984

Test-Taking & Test-Wiseness

Test Score

Preparation Performance(Before the exam) (During the exam)

5

Test-Taking & Test-Wiseness

Test Score

Preparation(Before the exam)

Self-Directed Learning Methods

Develop a Strategy

Choose strategy to meet your needs

Reading

50% of time should be spent reflecting

Strengthen Comprehension

Paraphrasing (increase understanding)

Outline major points

Total-Time Hypothesis (Ebbinghaus 1880s)

Reading next day (Distributive Trials)

Reduces time required to “relearn it”

Increase memory

Self-Directed Learning Methods

6

Understand It (Maddox 1964)

Meaningless Facts memorized

Day 5 = Recall ~ 40%

Day 30 Recall < 10%

Principles Understood

Day 5 = Recall > 95%

Day 30 Recall > 90%

Self-Directed Learning Methods

Self-Evaluation

Be sure “Closing the Gap”

Question-and-Answer Sessions (Books)

Maximize potential

Self-Directed Learning Methods

Question-and-Answer Books

Answer one question per minute

Do not use tutor mode

Self-Directed Learning Methods

7

Question-and-Answer Books

When checking work

o Review the incorrect answers

Self-Directed Learning Methods

Escape Syndrome

Sitting around thinking about/talking

about “how bad it’s going to be”…

This is a “stupid” exam, doesn’t test the real

me or how I relate to patients

Self-Directed Learning Methods

Test-Taking & Test-Wiseness

Test Score

Performance(During the exam)

8

Focus on the Stem – read the question first

Find the BEST answer

Read ALL options before recording answer

Avoid partly correct responses

Go with instinctive (GUT) feeling

You picked it for a reason

During the Examination

During the Examination

Once decide incorrect or guess

Do not consider it again

The phenomena of “pilot” questions

Get over negative self-talk

Avoid “reading into” the question

The stem sets the task

When GUESSING is the ONLY alternative

General AlternativeIf four of the five options are very specific and one is

very general…

Often the more general option is correct response

During the Examination

9

When GUESSING is the ONLY alternative

Longest AlternativeOften the exam writer wants to be sure you have

enough information to recognize the correct

Response.

During the Examination

When GUESSING is the ONLY alternative

Longest Alternative

During the Examination

What is a component of potential energy?

A. Upward reactive force

B. Energy of movement

C. Newtons and distance

D. Time

E. Gravity’s relationship to mass times its

acceleration

When GUESSING is the ONLY alternative

Similarity & Oppositeness If two choices are very similar, usually the correct

choice is NOT one of them…

The correct response is often one of two opposites.

During the Examination

An 80 lb child is sitting on one end of a seesaw. If another 80 lb child jumps from a high platform onto the other end of the seesaw, what will happen?

A. The first child will stay stationary on the ground

B. The first child will be lifted into the air, but remain seated

C. The seesaw will remain in neutral position

D. The second child will bounce off the seesaw

E. The second child will break their neck

10

When GUESSING is the ONLY alternative

Grammar Agreement The stem and responses should be grammatically

correct…

Singular stem should not be completed by plural

option

During the Examination

When GUESSING is the ONLY alternative

Grammar Agreement

During the Examination

A well uses what type of simple machines to raise

and lower a bucket?

A. Block

B. Tackle

C. Third-class lever

D. Wedge

E. Wheel and axle

When GUESSING is the ONLY alternative

Specific Determiners The implication of absoluteness (always, never,

must, none, only…) is often incorrect.

Words that permit exception (seldom, usually, often,

perhaps, etc) are more commonly associated with

the correct response.

During the Examination

11

When GUESSING is the ONLY alternative

Rank OrderWhen a list of numbers or “rank ordering” exists, the

correct response is often somewhere in the middle.

One horsepower is equivalent to

A. 724 watts

B. 746 watts

C. 768 watts

D. 782 watts

During the Examination

When GUESSING is the ONLY alternative

Deductive Approach (Convergence)A. W & X

B. Y & Z

C. X & Y

D. V & Z

E. X & Z

During the Examination

When GUESSING is the ONLY alternative

Deductive Approach (Convergence)A. W & X V = 1

B. Y & Z W = 1

C. X & Y X = 3

D. V & Z Y = 2

E. X & Z Z = 3

During the Examination

12

When GUESSING is the ONLY alternative

Clang Association Similarity between a word in the stem and correct

response.

If a question askes about tests for medial and lateral

ligament concerns, then look for varus and valgus

During the Examination

Research indicates:

Optimal amount of stress (maximizes performance)

Yerkes-Dodson Law 1908

High

Efficiency Test Anxiety

Low

Low Anxiety High

Test Anxiety

Can Cause

Psychological Changes GI Symptoms, Insomnia, Headaches

Emotional Changes Irritability, Moodiness, Frustration, Anger

Cognitive Changes Memory Blocks, Attention Span Limitations

Test Anxiety

13

Caused by

Lack of Preparation Cramming

Procrastination

Poor Study Habits

Prior history of poor performance

Worrying

Test Anxiety

Ways to Reduce

Understand the Examination

Build Confidence Study effectively & efficiently

Planned study time

Improve Test Taking Skills and use

when doing practice questions

Test Anxiety

Test Anxiety

Develop Stress Reduction Techniques Avoid caffeine

Exercise regularly

Breathing control

Muscle relaxation

Talk regularly to your mentors and cheerleaders

14

Summary

Test-Taking & Test-Wiseness

Familiarity with Examination

Critical Reading of Q & A

Error-Avoidance Techniques

Time-Management Techniques

Deductive-Reasoning Skills

References 1. McGaghie WC, Downing SM, Kubilius R. What is the Impact of Commercial Test

Preparation Courses on Medical Examination Performance?

Teaching and Learning in Medicine. 2004;16(2):202-211.

2. Werner LS, Bull BS. The Effect of Three Commercial Coaching Courses on Step One USMLE Performance.

Medical Education. 2003;37:527-531

3. Regehr G, Norman GR.Issues in Cognitive Psychology: Implications for Professional Education.

Academic Medicine. 1996;71(9):988-1001

4. West DC et al. Critical Thinking in Graduate Medical Education.

JAMA. 2000;284(9):1105-1110

5. Einhorn HJ, Hogarth RM.Confidence in Judgment: Persistence of the Illusion of Validity.

Psychological Review. 1978;85(5):395-416

6. Higbee, KL. Your Memory. How It Works and How to Improve It.

Marlowe & Company. 2001 ISBN: 1-56924-801-X

References7. Quirk, ME. How to Teach and Learn in Medical School.

Charles C. Thomas – publisher. 1994 ISBN: 0-398-05925X

8. Skakun EN, Maguire TO, Cook DA. Strategy Choices in Multiple Choice Items.

Academic Medicine. 1994;69(10):S7-S9

9. Millman J, Bishop CH. An Analysis of Test-Wiseness.

Educational and Psychological Measurement. 1965;25(3):707-726

10. Evans W. Test Wiseness: An Examination of Cue-Using Strategies.

Journal of Experimental Education. 1984;52(3):141-144

11. Dolly JP, Williams KS.

Using Test-Taking Strategies to Maximize Multiple-Choice Test Scores. Educ and Psych Measurement. 1986;46(3):619-625

12. Norman GR et al. Factors Underlying Performance on Written Tests of Knowledge.

Medical Education. 1987;21:297-304

13. ASVAB Mechanical Comprehension Test, ASVABPracticeTests.com