Study SmarterTM Effective Study Strategies for the ECFVG Basic Clinical Sciences Exam (BCSE) Steven I McLaughlin DVM, MPH, DACVPM [email protected] www.Zukureview.com 1 800 928 8218 “It is not enough to be a good chess player, you must also play well.” -Savielly Tartakower A Story Once upon a time, there was a world called veterinary medicine, covered in many forests. One forest was called “Pharmacology”; another “Physiology” and so on. In the Pharmacology forest, there were many trees. One tree was called “Antibiotics” and another called “Antiparasitics”. On that antibiotics tree was a single leaf called “Rifampin” One day, a good-hearted but near-sighted vet student wandered into the pharmacology forest, and got so engrossed studying a leaf on a single tree that she got lost, and a big bad wolf called BCSE came and ate her. The End let this be your map .The need for speed It is time to go fast. people. • The goal is not to know everything • The goal is not to get every question right • The goal is to pass In the forests of knowledge. This presentation • BCSE Structure • Study strategies for BCSE • Test-taking strategies BCSE . avma.BCSE Structure • 225 Multiple choice questions • One continuous 225-question block – 220 minutes (almost 4 hours!) – ~1 minute per question – “Many with graphics” • 25 questions are “pre-test” items – Not scored – Cannot tell which questions are “pretest” – Presumably being evaluated for use in future BCSE exams • No breaks once you start Source: http://www.asp#intro .org/education/ecfvg/bcse_bulletin. the ECFVG has released no data on the numbers of people taking BCSE or the numbers passing Source: http://www.BCSE Pass Rates ? To date.avma.org/education/ecfvg/bcse_bulletin.asp#intro . designed to assess basic and clinical veterinary sciences knowledge. The knowledge level expected ……of an entry-level US veterinarian (ie. Tox.BCSE Topics: Not exactly “laser focused” 1) 2) 3) 4) 5) 6) 7) Anatomy Physiology. Pharm.org/education/ecfvg/bcse_bulletin..” Source: BCSE Candidate Bulletin http://www. Pathology Medicine Surgery and anesthesia Diagnostics Preventive medicine 18-22 Qs (~9%) 24-28 Qs (~12%) 22-26 Qs (~11%) 42-50 Qs (~20%) 34-38 Qs (~16%) 26-30 Qs (~12%) 18-22 Qs (~9%) BCSE is like a “mini-NAVLE” “…. new graduate of an AVMA-accredited veterinary school) .avma.asp#outline . with signature – Name on BOTH i.d.s must match ATT name • No personal belongings allowed in test room – No calculator. brimmed hats.org/education/ecfvg/bcse_bulletin_pf.asp#identification . and name (ie: driver’s license.d. purse or coat • What is allowed ? – Erasable whiteboard provided for calculations – Some people bring earplugs Source: http://www. with signature. number – Must have TWO forms of identification • Photo-i.d.avma.Worth Remembering on Test Day • Must show up 30 minutes early – Must have Authorization to Test (ATT) letter w/ unique i. passport) • Secondary i. cell phone or digital watch – No food or drink – No backpack.d. ) • Who wants to waste time and money taking this test more than once? .Why bother to study effectively ? • BCSE is foundational knowledge – Concepts support your NAVLE prep – AND help you in clinics • Use motivation of BCSE to learn how to learn (This isn’t the last test you’ll ever take…. com/mvm/htm/bc/mgnrs903.com/mvm/htm/bc/mgnrs905. superficial cells in canine estrus (angular.com/mvm/index. no neutrophils). sharp edges like corn flakes.htm and in diestrus http://www.merckvetmanual.htm Source: Merck Vet Manual http://www.jsp?cfile=htm/bc/181903. Full cornification usually coincides with receptivity.htm .merckvetmanual.Example of a BCSE-style question Which stage of the canine estrous cycle is characterized by > 90% cornified epithelial cells with pyknotic nuclei and a lack of neutrophils in a vaginal smear? Remember: "CORNflakes go with MILK.merckvetmanual. tiny pyknotic nuclei or no nuclei." (A) Late diestrus (B) Late estrus (C) Early diestrus (D) Early proestrus (E) Anestrus Think > 90% CORNified. Follow this link to see a vaginal smear from a dog in estrus http://www. php and the Merck Manual online . wait 2 months (E) Not in heat yet Source: The Zuku Review.merckvetmanual.Example of a NAVLE-style question You are assisting a dog breeder decide when to breed her prize Siberian mousehound. A vaginal smear looks like this: http://www.com/mvm/htm/bc/z-mgnrs905.htm What would you recommend to the owner ? (A) Cannot say from this slide (B) Cannot say with only one smear (C) Breed the dog today (D) We missed her estrus.com/index. online veterinary test prep http://zukureview. where do I start? Be guided by BCSE example questions http://www. try the PAVE QE practice test . http://www.nbvme.org/?id=35&page=QE+Sample+Questions .If the BCSE is so broad.avma. For more practice.org/education/ecfvg/bcse_practice_test. style of questions Note: BCSE questions are similar to the QE.asp – A springboard to study – A pointer to key topics – Gives you a sense of the depth. nbvme. similar to the BCSE http://www.Where to start? An example Which of the following changes occurs as a result of metabolic acidosis? (A) Oxygen-hemoglobin saturation curve shifts to the left (B) Plasma becomes hypotonic (C) Plasma ionized calcium concentration increases (D) Serum glucose concentration increases (E) Serum potassium concentrations decreases Suggests “physiology & acid base” worth a review Source: Example from PAVE QE practice test.org/?id=35&page=QE+Sample+Questions . similar to the BCSE http://www.Where to start? Another example Which of the following is the most likely finding on a leukogram from a cow with a large chronic abscess? (A) Monocytosis with left shift and toxic change (B) Neutropenia and eosinopenia (C) Neutropenia and monocytosis (D) Neutropenia with left shift and toxic change (E) Neutrophilia and monocytosis Suggests “Clin Path / white cell function” worth a review Source: Example from PAVE QE practice test.nbvme.org/?id=35&page=QE+Sample+Questions . Successful learning means using the hours you do have effectively. MPH. Zuku (Steven I Mclaughlin DVM.” -Dr. DACVPM) .Study Smarter TM “Successful learning is not measured by how many hours you study. …. But Monday.A study technique that doesn’t work “I spent 6 hours reading endocrinology on Saturday. I didn’t remember any of it !” “Reading = Learning” .. if you make good notes .USE IT OR LOSE IT • MOST adults forget 50% of what they just read • And 80% within 24 hours BUT !! • Anything you have studied well will come back very quickly with a review …. Sack and Wensing Textbook of Veterinary Anatomy No “take home message” here! Learn to recognize the most important 3 points .Another study technique that doesn’t work Treating every single factoid as if it were important Ref: Dyce. Study Smarter TM • Start with a calendar – Map out your study plan. week by week – Make test prep part of your routine • First Pass: finish 3 weeks before test – All study-mode tests – Write out summary notes • Second Pass: during the 3 weeks before test – All test-mode tests – Review summary notes . complete summary notes 3 weeks before the test .Study strategies for BCSE The 50:50 rule Study ~50% -Map out the topic -Hit the books -Write summary notes -REVIEW those NOTES Practice testing ~50% -ROUTINE a couple times a week Goal: Finish study-mode tests. DxImaging #1. Study: Write summary notes on the 5 topics ~ 2 hours Wednesday: Tests: Do My Missed Questions from yesterday to reinforce Start new tests-ClinAnat #3. Physio #1 etc.Surg#2.Surg#1.Pharm #1.Pharm #2.Pharm #3.. Physio #2 etc.etc . Study: Quick review of summary notes from Tuesday Quick read of 5 new disease topics ~ 1 hour …………. Note mistakes.Surg#3.DxImaging #3. Physio #3 etc.BCSE Study Plan: First Pass Monday: Tests: ClinAnat #1.DxImaging #2.ClinAnat #2. ~1 hr Study: Quick read of 5 key disease topics ~ 1 hour Tuesday: Tests: Do My Missed Questions from yesterday to reinforce Start new tests. never more then 5 ideas per topic • Add “Mental Velcro” – Images – Disease examples .Summary notes: 50% of your time • Why write summary notes? – Translates info into language your brain understands – Customized notes worth weight in gold in weeks before test • Map out the topic – DON’T reinvent the wheel – Use textbook table of contents or class syllabus • The rule of 5. All rights reserved. ACVIM. DVM. Terri Defrancesco.Mental velcro: Images A picture IS worth a thousand words: Add pictures to your notes Fluid-filled lungs: Pulmonary edema “Floating lungs”: Pleural effusion Images courtesy of Dr. copyright 2007-2010 . org/wiki/File:Horner %27s_syndrome_dog. 3rd lid protrudes. PTOSIS (drooped eyelid). Ptosis) and "sweaty horses". Joel Mills. PROTRUSION 3rd eyelid (nictitans) 3. A syndrome. ENOPTHALMOS (sunken eye) 4. not a disease per se. Dr.Mental velcro: Disease Horner’s Syndrome: Remember "My 3rd Sunken Toe“ (Miosis.wikimedia.JPG . Wikimedia Commons See 4 things with Horner's. Sunken eye. +/anisocoria http://commons. ALL associated with the eye: 1. What is it? Image courtesy. MIOSIS (constricted pupil-lose sympathetic innervation) 2. To figure out where you are (and to get where you want to go). looking at a tree called “Misc antibiotics” and a leaf called “Rifampin”. Visualize where you are from 10.000 feet up .Map Out Your Topic You are on the ground in the forest of “Pharmacology”. Map example: Pharmacology Map from 10. Contraindications d. “mental velcro” (Image. Chloramphenicol 2. ‘cidals B. Rifampin 3. Misc antibiotics 1. Antibacterials A. ‘statics C. Cautions e. Gen info b. Misc antibiotics 5 “keys” Key Cardio drugs Key Optho drugs Key Repro drugs Key Endo drugs Key Renal drugs Misc Key antidotes/tox reversal agents Analgesics Tranquilizers Map from 100 feet C. Metronidazole Map on the ground You are here 2. Rifampin a. Primary use c.000 feet Map from 1000 feet 5 “Antis” Antibacterials Antifungals Antiparasitics Antivirals Antineoplastics I. disease) . jsp?cfile=htm/bc/191282. tears.General-‘cidal or ‘static dep.Mental velcro.htm . sweat 2). Don’t use alone or see rapid resistance 3).com/mvm/index. Merck Vet Manual online. Rifampin 2.Caution 1).992-4. Give on empty stomach e. pp. Rifampin a. http://www.merckvetmanual. May cz red-orange urine.Contraindication -Beware in hypersens animals.Summary notes part 1: Pharmacology. young horses c.Rhodococcus equi References: Plumb’s Vet Drug Formulary 5th ed. on microbe b. hepatic dysfxn d.Primary use -Rx Rhodococcus equi. edu/Content/27/imagegallery/367446/367480 .Summary notes part 2: Rifampin Mental velcro (image and a disease) References: Pasquini. DVM. 3 rd ed. D.tufts. Angeline Warner. Pasquini & Woods. p. 113 Notes developed by senior veterinary student for educational use preparation for NAVLE Image courtesy. Guide to Equine Clinics. Sc: http://ocw. p. Guide to Equine Clinics.Where to get a fast disease summary From: Pasquini. Pasquini & Woods. 113 . 3 rd ed. .Outside a dog. a book is a man’s best friend. it’s too dark to read. Inside a dog.Groucho Marx If you believe everything you read. .Japanese proverb . better not read. You put on your running shoes and run.” -Dr. Zuku .Practice testing for BCSE: 50% of your time “You don't get ready for a marathon by reading a book about it. We like this one. 4th ed. Pharmacology: *Plumb’s Veterinary Drug Handbook. Superb. Plumb – The original and a favorite. 7th ed. 4th ed. Tilley & Smith eds.—Chris & Susan Pasquini Blackwell's 5 Minute Veterinary Consult. Clinical Anatomy: Anatomy of Domestic Animals 10th edition— Pasquini. – 35 excellent case studies in appendix. Donald C. good tune up on basics.Recommended books for BCSE For medicine and disease summaries: Bovine: *Guide to Bovine Clinics 4th edition—Chris & Susan Pasquini Equine: *Guide to Equine Clinics 3rd edition—Chris & Susan Pasquini. but other texts are also good. FAR easier to navigate than Duke’s Clinical Pathology: Duncan and Prasse's Clinical Pathology. *Tschauner's Guide to Small Animal Clinics 2nd ed. Study those. basic surgery: Clinical Textbook for Vet Techs. 1st ed. Canine-Feline 4th ed. Cunningham and Klein – Good case-based organization. McCurnin & Bassert – Great images. Spurgeon and Pasquini – On almost every page you find a box that tells the clinical significance. dentistry. Phil Woods Dogs and Cats: *Veterinary Clinical Advisor. available as a book or online through VIN Physiology: Veterinary Physiology. Cote' ed. Make short notes. diseases associated with that part. Dogs and Cats. 5th edition. Anesthesia. Go fast. TM *Zuku Review Pick of the Litter . • Key to success: Train yourself to MAKE CHOICES and then MOVE ON. .Multiple choice tricks of the trade • The Good News Correct answer is GUARANTEED to be among the choices • The Bad News You WILL hit questions you don’t know Common mistake: Spending MOST of your time on questions about which you know the LEAST. org/education/ecfvg/bcse_practice_test.avma.Sources of practice questions • BCSE sample test http://www. Question Archive http://zukureview.com/ • Zuku Review BCSE course.asp • QE sample test (similar to BCSE) http://www.nbvme.org/other/resources.html • Mosby’s Basic and Clin sciences questions .PHP • CAPC parasitology test http://www.com/QOD_Archive.veterinaryboardgames.org/?id=35&page=QE+Sample+Questions • Vet Board Games cards http://www.capcvet. and MOVE ON . choose from what’s left.Multiple choice tricks of the trade • READ the question first (DON’T look at answers) • PREDICT the answer (protects you from distractors) • Is your answer the best of the choices ? If “Yes” SELECT it and move on • Unsure of the correct answer ? ELIMINATE wrong ones. . Whittle the choices down to as few as possible and guess. Predict. what do I do?” Read.“What if I don’t think this system will work for me ?” Do what works for you. Select -The correct answer is guaranteed to be among the choices. “How do I know when I should I change an answer ?” Stick with your first answer unless you recognize that it is clearly not correct .studies show that changed answers are more frequently wrong. Eliminate. “I am clueless about chickens/cardiology/box turtle halitosis. most new info fades from memory • Note questions you miss today on scratch paper • Redo “Missed Questions” tomorrow – Reinforces weak areas fast . ….IF you redo missed question within 24 hrs • After 24 hours...The 24-hour “golden period” period of short-term memory • A mistake is the best teacher – Mistakes sting – Sting helps you remember. Pop Quiz What is a Cook's speculum? A) B) C) D) Three-pronged ear speculum Four-pronged rectal speculum Three-pronged nasal speculum Three-pronged rectal speculum Multiple choice tricks of the trade: Convergence What is a Cook's speculum? A) B) C) D) Three-pronged ear speculum Four-pronged rectal speculum Three-pronged nasal speculum Three-pronged rectal speculum This is an example of convergence. Options A, C and D all contain the words "three-pronged“ Options B and D both contain the word "rectal." These two sets converge at option D Adapted from: Leo M. Harvill, Ph.D. “The Test Of Obscure Medical Information” Multiple choice tricks of the trade: Prognosis Questions about prognosis tend to be all or nothing (ie: clearly GREAT or clearly HORRIBLE) Prognosis/success rates by percentage: Excellent Good Guarded/Fair Poor Grave 90-100% 65-89% 35-64% 11-34% 1-10% (ave: 95%) (ave: 75%) (ave: 50%) (ave: 25%) (ave: 5%) Ref: Pasquini's, Tschauner's Guide to Sm. An Clinics, vol 1, 2nd ed. p. 11 Check for diaphragmatic hernia (bowel loop in chest) • Straining to urinate? Check bladder for stones • Regurgitation? Check for lung field for megaesophagus • No normals. UNLIKELY to see picture with nothing wrong .Good images are hard to get. dislocation.Multiple choice tricks of the trade Images • CENTER Most photographers put lesion centrally in photos • Radiographs are an exception – Must look over WHOLE x-ray – History gives clues • Hit by car? Check for pelvic or femoral fracture. com/mvm/htm/bc/z-exlha29. center of image Click this version for explanatory text: http://www.com/mvm/index.If there is a problem in this picture. Hamster.merckvetmanual.com/mvm/htm/bc/z-exlha29.htm Intussusception.htm Reference: The Merck Veterinary Manual online edition http://www. where is it ? (click link) http://www.jsp .merckvetmanual.merckvetmanual. Where is the problem? Image courtesy. canine leishmaniasis . Dr. Peter Schantz Tongue ulcer. Kim Stanz What is it? Ulcer. possible descemetocoele .Where is the problem? Image courtesy. Dr. mitral valve . Terri Defrancesco What is it? Endocardiosis.Where is the problem? Image courtesy. Dr. Scot Nachbar .What. is wrong with this picture? History Hint: This cat is having urinary accidents Bladder stones Image courtesy. if anything. Dr. Dr.If anything is wrong with this picture. in which quadrant is the problem? History Hint: This beagle was hit by a car Upper left quadrant. Scot Nachbar . Ilial fracture Image courtesy. Dr. is wrong with this picture? History Hint: This 6 month old Labrador regurgitates soon after eating Megaesophagus: note ventral deviation of tracheal carina.What. dilation of esophagus Image courtesy. Terri Defrancesco . if anything. jsp? cfile=htm/bc/mvm_list_img.vet.ca/clinpath/banq-im/menuE.umontreal.htm .php?id=2355 Clin Path Case studies http://www.k-state.edu/depts/VMTH/radiology/cow/index.htm Tech hint: Right-click your mouse over an Clin Path images internet image.org/AnimalOwners/HealthConditions/ Radiology case studies http://www.vet.com/mvm/index.medvet.umontreal.medvet.osu.cornell.com Merck images online http://www.htm Radiology artifacts http://vet.edu/nst/nst.aspelsewhere Vet video library: www.htm to copy and paste it Pathology/Histopathology images http://w3.acvs.merckvetmanual. http://www.ca/clinpath/choice.edu/index.vetvideos.Online Case Study & Image Resources Surgery case studies http://www. you change your training to mimic the race. Zuku . change your study to mimic the real test” -Dr. In the final weeks before test day.The final 3 weeks Second Pass “In the final weeks before a big race. The final 3 weeks Second Pass Study -REVIEW your notes -Skim misc topics not in notes -Test yourself with flashcards. friends. game cards Practice testing Do timed test-mode tests -60-question tests build stamina -Random topics -No answers as you go -Mimics the real thing Goal: Finish all test-mode tests Redo “Missed questions” within 24 hours Review summary notes until solid in your mind . square-dance. then notes review • Get your mind & body into a routine so the big day feels routine too • Don't give up.about same time you need to wake up on test day • Start with a decent breakfast • Go immediately into 2 hours of practice tests. swim. …. walk in with your head held high. • On test day. hamster or wombat • Get up early every day.The final 3 weeks Keep a routine • Get regular exercise …Run. and take it one question at a time . walk your dog. Remember 4 things 1. Try to finish first pass on summary notes & study-mode tests 3 weeks before test 4. ~50% practice testing 2. Redo “missed questions” w/in 24 hours 3. In final 3 weeks do test-mode tests. ~50% study. review notes . or Eliminate – Redo "My Missed Questions“ w/in 24 hours – Pay attention to images in questions – Finish all test-mode tests in final week • Stay Positive – Panic is not productive. Predict.If Time is Short • ~1/3 time reviewing notes • ~2/3 time taking tests – Read. don’t waste energy on it – Test-takers with forward momentum and a positive attitude do better on tests – Do what you can. keep moving. Select. and don't give up . Good luck! “No student knows his subject: the most he knows is where and how to find out the things he does not know.” –Woodrow Wilson . asp BCSE practice test http://www.org/?id=35&page=QE+Sample+Questions Web version: http://nbvmepractice. co-founder of The Princeton Review test preparation company George Washington University Academic Success Center. Ph.References The summary of multiple choice strategies comes principally from: “What Smart Students Know” by Adam Robinson.org/education/ecfvg/bcse_practice_test. Harvill.starttest.avma.avma.asp QE practice tests Text version: http://www.nbvme.com/ .“Strategies for Multiple Choice Questions” Kaplan Test Prep US Medical Licensure Exam (USMLE) Strategy Sessions Convergence concept Adapted from: “The Test Of Obscure Medical Information” Leo M. ECFVG Candidate Bulletin http://www.org/education/ecfvg/bcse_bulletin.D. Extra slides . 259-60 & Pasquini& Pasquini. 703 Notes developed by senior veterinary student for educational use preparation for NAVLE Image source unreferenced. pp. Tschauner’s Guide to Small Animal Clinics. Dogs and Cats. Veterinary Clinical Advisor. p.Another example of good notes References: Cote’. May be used only for educational purposes . 1st ed. 2 nd ed. Another Example of Convergence Budin's rule states that the amount of cow's milk consumed per day for a bottle-fed baby should be approximately of the weight of the baby. A) B) C) D) 1/10 1/8 1/7 2/10 . B and C are similar: they have “1” in the numerator. A test-wise examinee will choose A because it appears in both sets above.Multiple choice tricks of the trade: Convergence Budin's rule states that the amount of cow's milk consumed per day for a bottle-fed baby should be approximately of the weight of the baby. The correct answer is A. Adapted from: Leo M. A and D are similar: they have “10” in the denominator. Ph. Harvill.D. A) B) C) D) 1/10 1/8 1/7 2/10 A. “The Test Of Obscure Medical Information” .