Study SmarterTM Effective Study Strategies for the North American Veterinary Licensing Exam (NAVLE ®) 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 ―Dogs‖; another ―Pigs‖ and so on. In the Dog forest, there were many trees. One tree might be called ―Cardiology‖ and another called ―Endocrinology‖. On that Cardiology tree might be a single leaf called ―Dilated Cardiomyopathy‖ One day, a good-hearted but near-sighted vet student wandered into the Dog forest, and got so engrossed studying the bark on a single tree that she got lost, and a big bad wolf called NAVLE came and ate her. The End let this be your map . 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.The need for speed It is time to go fast. Today‟s talk: North American Veterinary Licensing Exam® (NAVLE) • NAVLE structure. pass rates • Study strategies for NAVLE • Test-taking strategies for NAVLE . get extra break time Reference: NBVME NAVLE FAQs page http://www.org/?id=71 .NAVLE Structure • 360 questions. takes all day • Six 60-question blocks – – – – 65 minutes per block ~1 minute per question ~10% of questions have images 60 questions not counted during scoring • Breaks – No break once you start a block – 45 minutes break-time available between blocks – If finish block early.nbvme. org/?id=82 . same period *First time test-takers.NAVLE Pass Rates Senior Students. AVMA Accredited Veterinary Schools Fall 2005-Spring 2009 Overall Fall 05‘-Spring 06‘ Fall 06‘-Spring 07‘ Fall 07‘-Spring 08‘ Fall 08‘-Spring 09‘ Pass 95% (2549/2686) 96% (2724/2841) 97% (2816/2903) 97% (2908/3009) Fall only* Fall 06‘ Fall 07‘ Fall 08‘ Fall 08‘ Pass 88% (2300/2616) 90% (2486/2760) 92% (2605/2828) 93% (2690/2880) Increasing pass rates 2005 through 2009 459-person increase in test-takers from accredited schools. AVMA accredited veterinary schools Reference: NBVME NAVLE results page http://www.nbvme. senior students. nbvme.NAVLE Pass Rates Senior Students & Graduates of Foreign Veterinary Schools Not Accredited by AVMA Overall Fall 05‘-Spring 06‘ Fall 06‘-Spring 07‘ Fall 07‘-Spring 08‘ Fall 08‘-Spring 09‘ Pass 41% (534/1312) 41% (628/1546) 54% (370/680) 64% (481/757) Fall only Fall 06‘ Fall 07‘ Fall 08‘ Fall 08‘ Pass 44% (308/698) 44% (352/799) 51% (242/476) 68% (271/398) Marked Increase in pass rates 2007 through 2009 Marked decrease in test-takers from non-accredited schools.org/?id=82 . same period Changes likely due to 2007 requirement to pass BSCE test prior to NAVLE Reference: NBVME NAVLE results page http://www. you don‟t pass the NAVLE by accident. Everyone has to prepare.” -Dr.NAVLE Pass Rates What do they mean to me? “No matter what the pass rates are. MPH. Zuku (Steven I Mclaughlin DVM. DACVPM) . must exactly match name on Sched.d. last names on i.Worth Remembering on Test Day • Show up 30 minutes early – Must have Scheduling Permit – Must have unexpired government-issued identification ie: • Driver's license or passport-includes both photo and your signature • First.org/?id=10&page=NAVLE+Candidate+Bulletin . permit • No personal belongings allowed in test room – No calculator. purse or coat • What is allowed ? – Erasable whiteboard provided for calculations – Some people bring earplugs Reference: NAVLE Candidate Bulletin: http://www.nbvme. cell phone or digital watch – No food or drink – No backpack. brimmed hats. nbvme.org/?id=26&page=NAVLE+Test+Specifications .NAVLE Structure 72 (24%) Canine: 72 (24%) Feline: 84% of the NAVLE 51 (17%) Bovine: 51 (17%) Equine: 12 (4%) Porcine: 9 (3%) Pet Birds: 9 (3%) Public Health and Food Security: 9 (3%) Ovine/Caprine/Cervidae: 6 (2%) Other Small Animals: 6 (2%) Poultry: 3 (1%) Non-Species Specific: 300 Reference: http://www. Remember Sutton‘s Law “Go where the money is” Most NAVLE points lie in the “Big 4” species . If the NAVLE is so broad.nbvme. where do I start? Be guided by NAVLE sample questions and NBVME self assessments – A springboard to study – A pointer to key topics – Gives you a sense of the depth. tutorial http://www.org/?id=80 NBVME Self-assessments http://www.nbvme.nbvme. style of questions References: Text Sample Questions http://www.org/?id=93&page=Self-Assessments .org/?id=23&page=NAVLE+Sample+Questions Computerized sample questions. Board of Veterinary Medical Examiners (NBVME) Self-assessments http://www. 200 questions.org/?id=93&page=Self-Assessments . 30 days‘ access – Two versions available.One of the best ways to prepare for NAVLE NBVME self assessments • Produced by same people who write NAVLE – $50. depth Link: Natl. both worth doing • DON‟T do all 200 questions in one sitting • DO 10-15 questions per day look up answers to the ones you don‟t know • Orients you to NAVLE-question style.nbvme. MPH.Study Smarter many hours you study.” -Dr. Zuku (Steven I Mclaughlin DVM. DACVPM) . TM “Successful learning is not measured by how Successful learning means using the hours you do have effectively. 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‖ .. 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 ….if you make good notes Another study technique that doesn‘t work Treating every single factoid as if it were important Ref: Dyce, Sack and Wensing Textbook of Veterinary Anatomy No “take home message” here! Learn to recognize the most important 3 points Study Smarter • Start with a calendar TM – Map out your study plan, week by week – Make test prep part of your routine • First Pass: finish 4 weeks before test – All study-mode tests – Write out summary notes • Second Pass: during the 4 weeks before test – All test-mode tests – Review summary notes complete summary notes 4 weeks before the test .Study strategies for NAVLE 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. Cow # 1. Quick read of 5 key disease topics ~ 1 hour Tuesday: Tests: 1. Look up answers to NBVME self assessment Qs you don't know .no more than 20 min per question 2. ~ 1 hour 2. Cross-species #1.page summary notes on the 5 topics ~ 2 hours ………………etc . Cat # 2. Horse #1. Do 10-15 NBVME self assessment Qs. Look up answers to NBVME self assessment Qs you don't know 2. Cat # 1. note the ones you don't know Study: 1. Do 10-15 NBVME self assessment Qs.NAVLE Study Plan Monday: First Pass Tests: 1. Dog #1. Write 1/2 . Start new tests-Dog #2. note the ones you don't know Study: 1. Do My Missed Qs from yesterday's tests-2. Cross-sp # 2 3. Horse #2. Cow # 2. 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. ACVIM. All rights reserved. Terri Defrancesco. DVM.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 . not a disease per se. 3rd lid protrudes.JPG What is it? Image courtesy. ALL associated with the eye: 1. PTOSIS (drooped eyelid). Dr. +/anisocoria http://commons. Wikimedia Commons . MIOSIS (constricted pupil-lose sympathetic innervation) 2. See 4 things with Horner's. PROTRUSION 3rd eyelid (nictitans) 3. Sunken eye.wikimedia.org/wiki/File:Horner% 27s_syndrome_dog.Mental velcro: Disease Horner‟s Syndrome: Remember "My 3rd Sunken Toe― (Miosis. Ptosis) and "sweaty horses". A syndrome. Joel Mills. ENOPTHALMOS (sunken eye) 4. looking at a tree called ―Fungal infections‖ and a leaf called ―Cryptococcus‖. To figure out where you are (and to get where you want to go). Visualize where you are from 1000 feet up .Map Out Your Topic: An easier clinical example-Cryptoccocosis You are on the ground in the forest of ―Small Animal Medicine‖. Prevention/Prognosis . Cocciomycosis C. Aspergillosis C. Cryptococcosis a. DDX c. Presentation b. humbugs” A. Blastomycosis B. Cocciomycosis B. Test of Choice d. Histoplasmosis Map on the ground You are here 2. Cryptococcosis 3 “BAH. Candidiasis A. Candidiasis B. Treatment e.Map example: Important Fungal Diseases Map from 1000 feet Map from 100 feet 3 “C‟s” 3 “C‟s” A. Cryptococcosis C. 1st ed. 259 -60 & Pasquini& Pasquini. 703 Notes developed by senior veterinary student for educational use in preparation for NAVLE Image source unreferenced. 2nd ed.An example of good summary notes: Cryptococcosis References: Cote‘. May be used only for educational purposes . Tschauner‘s Guide to Small Animal Clinics. pp. Dogs and Cats. p. Veterinary Clinical Advisor. looking at a tree called ―Misc antibiotics‖ and a leaf called ―Rifampin‖. To figure out where you are (and to get where you want to go).Map Out Your Topic: A harder example-Pharmacology You are on the ground in the forest of ―Pharmacology‖.000 feet up . Visualize where you are from 10. Chloramphenicol 2. Metronidazole Map on the ground You are here 2. „cidals B. Cautions e.000 feet 5 “Antis” Antibacterials Antifungals Antiparasitics Antivirals Antineoplastics 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 1000 feet I. disease) . Misc antibiotics Map from 100 feet C. Primary use c. Rifampin 3. Misc antibiotics 1. „statics C.Map example: Pharmacology Map from 10. Contraindications d. Antibacterials A. “mental velcro” (Image. Rifampin a. Gen info b. 992-4. Rifampin a. pp. Don‘t use alone or see rapid resistance 3).merckvetmanual.com/mvm/index.Summary notes part 1: Pharmacology. on microbe b. http://www. May cz red-orange urine.jsp?cfile=htm/bc/191282.htm . tears.Primary use -Rx Rhodococcus equi. Rifampin 2.Contraindication -Beware in hypersens animals. young horses c.Rhodococcus equi References: Plumb‘s Vet Drug Formulary 5th ed. hepatic dysfxn d. Give on empty stomach e. Merck Vet Manual online. sweat 2).General-‗cidal or ‗static dep.Caution 1).Mental velcro. Sc: http://ocw.Summary notes part 2: Rifampin Mental velcro (image and a disease) References: Pasquini.tufts. Angeline Warner.edu/Content/27/imagegallery/367446/367480 . 113 Notes developed by senior veterinary student for educational use preparation for NAVLE Image courtesy. DVM. 3rd ed. Pasquini & Woods. D. Guide to Equine Clinics. p. Guide to Equine Clinics.Where to get a fast disease summary From: Pasquini. 3rd ed. Pasquini & Woods. p. 113 . Where to start with summary notes • Summarize most important diseases first ie: – Heartworm more important than aortic coarctation (whatever that is) – Diabetes mellitus more important than pheochromocytoma – Equine laminitis more important than rare rachitic ringbone • Not sure where to start? • See suggested “Top 20s” on the Zuku Review website • Feeling ambitious? The 2003 NAVLE Job Analysis survey lists about a 1000 conditions you can bone up on……. http://nbvme.org/?id=13&page=NAVLE+Job+Analysis+2003 . better not read.Outside a dog. a book is a man‟s best friend.Groucho Marx If you believe everything you read. Inside a dog. .Japanese proverb . . it‟s too dark to read. Dogs and Cats.—Pasquini Equine: *Guide to Equine Clinics 3rd ed. available as a book or online through VIN Clinical Pathology: Duncan and Prasse's Clinical Pathology.—Pasquini Blackwell's 5 Minute Vet Consult. Pharmacology: *Plumb‘s Veterinary Drug Handbook. 5th edition. Canine-Feline 4th ed.Recommended books for NAVLE For medicine and disease summaries: Bovine: *Guide to Bovine Clinics 4th ed. Tilley & Smith eds. Donald C.—Pasquini & Woods Dogs and Cats: *Veterinary Clinical Advisor. Plumb – The original and a favorite. Cote' ed. *Zuku Review Pick of the Litter TM . We like this one. – 35 excellent case studies in appendix. but other texts are also good. *Tschauner's Guide to Small Animal Clinics 2nd ed. 1st ed. 4th ed. Zuku .Practice testing for NAVLE: 50% of your time “You don't get ready for a marathon by reading a book about it. You put on your running shoes and run.” -Dr. • 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. . and MOVE ON .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. choose from what‘s left. Eliminate. “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 . Whittle the choices down to as few as possible and guess. . Predict.studies show that changed answers are more frequently wrong. “I am clueless about chickens/cardiology/box turtle halitosis. Select -The correct answer is guaranteed to be among the choices.“What if I don‟t think this system will work for me ?” Do what works for you. what do I do?” Read. ….IF you redo missed question within 24 hrs • After 24 hours..The 24-hour ―golden period‖ of shortterm memory • A mistake is the best teacher – Mistakes sting – Sting helps you remember. most new info fades from memory • Note questions you miss today on scratch paper • Redo “Missed Questions” tomorrow – Reinforces weak areas fast .. html Vet Board Games question of the day http://www.com/ce/MULT205-0909.veterinaryboardgames.htm Vetprep online NAVLE course http://www. Patricia Schenck DVM.org/?id=80 CAPC parasitology test http://www.nbvme.com/sb/web/ Zuku Review online NAVLE course http://zukureview.Sources of practice questions Free • • • • NAVLE sample tests Text version http://www.org/other/resources. 2009-no information available yet on contents) .php Other NAVLE prep aids • • Vet Board Games cards & iPhone application http://www. PhD (Paperback with CD-due out late Sept.com/QOD_Archive.com/index.nbvme.vetprep.com/ Saunders Comprehensive Review for the NAVLE®.vin.veterinaryboardgames.PHP Subscription-based • • • • NBVME Self Assessments http://www.org/?id=93&page=Self-Assessments VIN NAVLE prep course http://www.org/?id=23&page=NAVLE+Sample+Questions Computerized version http://www.capcvet.html Zuku Review Question of the day Archive http://zukureview.nbvme.com/qod. 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 . “The Test Of Obscure Medical Information” . C and D all contain the words "three-pronged“ Options B and D both contain the word "rectal. Options A.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.D." These two sets converge at option D Adapted from: Leo M. Ph. Harvill. vol 1. An Clinics. Tschauner's Guide to Sm. 11 . p. 2nd ed.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. 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. Check for diaphragmatic hernia (bowel loop in chest) • Straining to urinate? Check bladder for stones • Regurgitation? Check for lung field for megaesophagus • No normals. merckvetmanual.htm Intussusception.merckvetmanual.jsp . center of image Click this version for explanatory text: http://www. where is it ? (click link) http://www.htm Reference: The Merck Veterinary Manual online edition http://www.com/mvm/htm/bc/z-exlha29.If there is a problem in this picture. Hamster.merckvetmanual.com/mvm/index.com/mvm/htm/bc/z-exlha29. Where is the problem? Image courtesy. Peter Schantz Tongue ulcer. Dr. canine leishmaniasis . Kim Stanz What is it? Ulcer.Where is the problem? Image courtesy. Dr. possible descemetocoele . Where is the problem? Image courtesy. Terri Defrancesco What is it? Endocardiosis. mitral valve . Dr. Dr. if anything. is wrong with this picture? History Hint: This cat is having urinary accidents Bladder stones Image courtesy. Scot Nachbar .What. Dr. Ilial fracture Image courtesy. in which quadrant is the problem? History Hint: This beagle was hit by a car Upper left quadrant. Scot Nachbar .If anything is wrong with this picture. dilation of esophagus Image courtesy.What. Terri Defrancesco . Dr. is wrong with this picture? History Hint: This 6 month old Labrador regurgitates soon after eating Megaesophagus: note ventral deviation of tracheal carina. if anything. jsp?cfile=htm/bc/mvm_list_img.umontreal.merckvetmanual.org/AnimalOwners/HealthConditions/ Radiology case studies http://www.edu/nst/nst.cornell.htm .ca/clinpath/banq-im/menuE.ca/clinpath/choice.htm Clin Path images http://www.asp Vet video library: www.medvet.com/mvm/index.htm Pathology/Histopathology images http://w3.vetvideos.edu/index.osu.acvs.htm Radiology artifacts http://vet.php?id=2355 Tech hint: Clin Path Case studies http://www.k-state. to copy and paste it elsewhere Merck images online http://www.com Right-click your mouse over an internet image.edu/depts/VMTH/radiology/cow/index.vet.medvet.Online Case Study & Image Resources Surgery case studies http://www.umontreal.vet. In the final weeks before test day. change your study to mimic the real test” -Dr.The final 4 weeks Second Pass “In the final weeks before a big race. you change your training to mimic the race. Zuku . 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 .The final 4 weeks Second Pass Study -REVIEW your notes -Skim misc topics not in notes -Test yourself with flashcards. …. walk your dog.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. and take it one question at a time . then notes review • Get your mind & body into a routine so the big day feels routine too • Don't give up. walk in with your head held high. square-dance.The final 4 weeks Keep a routine • Get regular exercise …Run. • On test day. hamster or wombat • Get up early every day. review notes . ~50% practice testing Redo “missed questions” w/in 24 hours Try to finish first pass on summary notes & study-mode tests 4 weeks before test 4. In final 4 weeks do test-mode tests. ~50% study. 2.Remember 4 things 1. 3. If Time is Short • ~1/3 time reviewing notes • ~2/3 time taking tests – Read. Predict. Select. and don't give up . keep moving. don‘t waste energy on it – Test-takers with forward momentum and a positive attitude do better on tests – Do what you can. 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. 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 . NAVLE Candidate Bulletin http://www. Ph. tutorial http://www. co-founder of The Princeton Review test preparation company George Washington University Academic Success Center.org/?id=80 NBVME Self-assessments http://www.―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. Harvill.org/?id=10&page=NAVLE+Candidate+Bulletin Text Sample Questions http://www.org/?id=23&page=NAVLE+Sample+Questions Computerized sample questions.nbvme.References The summary of multiple choice strategies comes principally from: ―What Smart Students Know‖ by Adam Robinson.nbvme.org/?id=93&page=Self-Assessments .D.nbvme.nbvme.