Preparing for Licensure Examinations - American Association of

AACOM Annual Meeting 2012

Preparing for Licensure Examinations Lisa Travis, MS, EdS Medical Librarian, LMU-DCOM Chelsea A. Nickolson, OMSIII COSGP Medical Education Representative, LMU-DCOM Donald J. Sefcik, DO, MBA Senior Associate Dean, MSUCOM

Co-sponsored by

Council of Osteopathic Student Government Presidents Council of Osteopathic Librarians Society of Osteopathic Medical Educators March 30, 2012


Goal of this session From librarian, student, and faculty perspectives, this session will describe the current practices and best practices in preparing for the National Licensure Exams.


Part 1 – Librarian Perspective Survey about COMLEX-USA Level 1 Resources in 2010 and 2011 Survey about COMLEX-USA Level 2 Resources in 2012 So many review books and databases Few books available electronically for institutional purchase

COMLEX-USA Level 1 Survey 2010 – 205 students 2011 – 395 students 7 osteopathic medical schools

Q1: List the three books that you consider most helpful for reviewing for the COMLEX Level 1 exam. First Aid for USMLE OMT Review (Savarese) Rapid Review Pathology (Goljan) First Aid Kaplan Review Books Microbiology Made Ridiculously Simple BRS Physiology First Aid for COMLEX USMLE Step 1 Secrets BRS Pathology First Aid Cases Kaplan for COMLEX Step-Up to USMLE Step 1 (Mehta) Boards Boot Camp Materials BRS Kaplan COMLEX Level 2 BRS Biochemistry Crush Flashcards (generic)

2010

2011

47 18 34 24 26 8 5 4 1 1 1 11 3

95 61 56 53 30 22 12 7 6 4 4 4 4

1 1

3 3 3 2 2 2

Q3: Please identify the board review resource (book or non-book) that you consider to be the most helpful resource. COMBANK First Aid for USMLE First Aid Doctors in Training Kaplan Course USMLEWorld Rapid Review Pathology (Goljan) Boards Boot Camp Question banks (generic) OMT Review (Savarese) PASS Program BRS Pharmacology Flashcards (Kim) BRS Physiology ExamMaster USMLE Step 1 Secrets Wikipedia Microcards Unpublished notes USMLE Consult

2010

2011

3 17 16 2 7 14 3

24 19 18 12 11 11 7

1

4 4

1

2 2 1 1 1 1 1

1 1 1

COMLEX-USA Level 2 Survey Class of 2011 – 13/212 students (6.13%) Class of 2012 – 143/212 students (67.45%) Class of 2013 – 56/212 students (26.42%) 7 osteopathic medical schools


COMLEX-USA Level 2 Survey 212 responses – 1 incomplete 7 GA-PCOM 34 LMU-DCOM 46 NYCOM 18 OU-HCOM 43 PCOM 28 UNECOM 33 VCOM-VC


COMLEX-USA Level 2 Survey Three most helpful books – 15 responses 1st book (most helpful book) 3 – First Aid 3 – Step Up To Step 2 1 – Step Up To Medicine 1 - Boards and Wards by Carlos Ayala and Brad Spellberg 1 – Case Files 1 – Master the Boards 1 – Crush Step 2 1 – OMT review by Savarese 1 – NMS Series 1 – USMLE Step 2 (not a book) 1 – USMLEWorld (not a book)


COMLEX-USA Level 2 Survey Three most helpful books – 13 responses 2nd most helpful book 4 – First Aid 3 – OMT review by Savarese 2 – Step Up To Step 2 1 – Step Up To Medicine 1 – Crush Step 2 1 – Doctors in Training (not a book) 1 – COMBANK (not a book)


COMLEX-USA Level 2 Survey Three most helpful books – 8 responses 3nd most helpful book 5 – OMT review by Savarese 3 – First Aid


COMLEX-USA Level 2 Survey – How helpful for CE exam (19 options)? Very helpful – top five 42.93% (82/191) – COMBANK for COMLEX-USA Level 2 CE 40.64% (76/187) - USMLEWorld for USMLE Step 2 CK 34.20% (66/193) - COMQUEST for COMLEX-USA Level 2 CE 26.70% (51/191) – Doctors in Training for COMLEX-USA Level 2 CE 23.91% (44/184) – COMSAE Practice Questions for COMLEX-USA Level 2 CE


COMLEX-USA Level 2 Survey – How helpful for CE exam (19 options)? Not very helpful – top five 10.22% (19/181) – Exam Master for USMLE Step 2 CK 8.15% (15/184) - COMSAE Practice Questions for COMLEX-USA Level 2 CE 8.06% (15/186) – Kaplan Qbank for USMLE Step 2 CK 6.56% (12/183) – Northwestern Medical Review for COMLEX-USA Level CE 5.49% (9/164) – Falcon Review materials for COMLEX Level 2 5.39% (9/167) – Falcon Review materials for USMLE Step 2 CK


COMLEX-USA Level 2 Survey – How helpful for CE exam (19 options)? Not familiar with the resource – top five 95.81% (160/167) - USMLEWeapon 95.18% (158/166) – Score95 93.33% (167/180) – MasteringBoards.com for COMLEX-USA Level 2 CE 92.86% (169/182) – Premier Review for COMLEX-USA Level 2 CE 91.26% (167/183) – PASS Program for USMLE Step 2 CK; will design a program to meet a student’s needs as well


COMSAE Practice Questions for COMLEX-USA Level 2 CE 23.91% (44/184) - Very helpful 20.11% (37/184) - Helpful 21.20% (39/184) - Somewhat helpful 8.15% (15/184) - Not very helpful 26.63% (49/184) - Not familiar with resource


COMLEX-USA Level 2 Survey – How helpful for PE exam (9 options)? Very helpful – top three 14.59% (27/185) – COMSAE information for COMLEX-USA Level 2 PE (instead of “COMSAE information,” survey perhaps should have been worded as “NBOME information” or something similar since there isn’t a COMSAE PE practice exam and changing from “COMSAE practice questions” (CE) to “COMSAE information” (PE) was not clear enough) 13.71% (24/175) - USMLEWorld for USMLE Step 2 CS 5.11% (9/176) – Kaplan materials for USMLE Step 2 CS 2% or less - All other resources


COMLEX-USA Level 2 Survey – How helpful for PE exam (9 options)? Not very helpful – top five 10.81% (20/185) – COMSAE information for COMLEX-USA Level 2 PE (instead of “COMSAE information,” survey perhaps should have been worded as “NBOME information” or something similar since there isn’t a COMSAE PE practice exam and changing from “COMSAE practice questions” (CE) to “COMSAE information” (PE) was not clear enough) 6.36% (11/173) – Falcon Review materials for USMLE Step 2 CS 6.36% (11/173) – PASS Program for USMLE Step 2 CS; will design a program to meet student’s needs as well 6.25% (11/176) – Northwestern Medical Review for COMLEXUSA Level PE 5.11% (9/174) – Premier Review materials for USMLE Step 2 CS


COMLEX-USA Level 2 Survey – How helpful for PE exam? Not familiar with the resource – top five 93.71% (164/175) – Ximedus for USMLE Step 2 CS 91.48% (161/176) – MasteringBoards.com for COMLEX-USA Level 2 PE 91.38% (159/174) – Premier Review materials for USMLE Step 2 CS 91.33% (158/173) – Falcon Review materials for USMLE Step 2 CS 90.91% (160/176) – Northwestern Medical Review for COMLEX-USA Level 2 PE


COMSAE Information for COMLEXUSA Level 2 PE 14.59% (27/185) - Very helpful 20.00% (37/185) - Helpful 12.43% (23/185) - Somewhat helpful 10.81% (20/185) - Not very helpful 42.16% (78/185) - Not familiar with resource Note: Instead of “COMSAE information,” survey perhaps should have been worded as “NBOME information” or something similar since there isn’t a COMSAE PE practice exam and changing from “COMSAE practice questions” (CE) to “COMSAE information” (PE) was not clear enough


Best Review Resource – Book or Non-Book (15 responses) 4 – Doctors in Training 3 – First Aid 3 – COMBANK 2 – Kaplan Qbank 1 – COMQUEST 1 – Boards Boot Camp 1 – USMLEWorld

Survey Data and Results [email protected]


Part 2- Student Perspective • COMLEX-USA Level 1 is the unknown – How to study? – What to study?

• Time commitment – Keeping up with coursework – Maintaining balance

• Stress increase – – – –

Consequences of not passing Length of exam Attaining competitive score Cost of exam and prep materials


Stress Effects on Learning and Memory • Varies with type of learning – ↑Simple Recall – ↓Problem Solving

• Other Effects – – – –

Health and fitness Relationships Psych and mood BALANCE!


Mentorship • Students – OMS-III/IVs – National Organizations (COSGP!)

• Faculty • Physicians • Administration – Correlations

• Mentorship ≠ Sharing items from past/future exams • Stay Positive!


COMLEX-USA Level 1 Survey 2012 • Designed by COSGP Research Representative, Kevin Ku, OMS-IV • 458 Student Participants, OMS-IIIs only • 14 Schools Represented • Participation Window: 2/27/12- 3/27/12 • Data from April 2011 available for COMLEXUSA Level 2


Time To Study How much time off from classes did your school provide between second and third year for board studying?

69% 7%

What were you doing academically at the time you took COMLEX-USA Level 1?

18%

5%


Methods Used None Independent Study Informal Group Study Schoolsponsored, noncommercial review course Commercial review course/progr am Commercial question banks

Other

3

1%

401

90%

141

31%

73

16%

243

54%

377

84%

16

4%


Most Useful Source

Of the following, please indicate the #1 resource that you found the MOST helpful in your preparation


2nd Most Useful Source


Least Helpful Source Which resource did you find the LEAST helpful?


In Retrospect…PLANNING “More questions and setting a higher personal goal. I met mine, but then afterwards wondered what would have happened if I aimed for a 700 or 750 instead.” –Score of 602 “Study over a longer period of time, not try to memorize it all too late. Do more practice questions. Needed more time to study.” – Score of 380 “Started using my board review book during systems courses and more questions.” –Score of 500


In Retrospect…ANXIETY “I honestly believe I failed the first time not because I was under prepared but because I had too much anxiety and was way too 'in my head'. Perhaps if there was a course on handling stress during these exams or even just an assembly of solid facts on how much our board scores affect our residency applications.” –Score of 390


In Retrospect…TIMING “I started USMLE World too early, I think it would have been more beneficial to work through it closer to my exam date” –Score of 674 “Focus more last week ... Was burned out when I took my test and couldn't focus” –Score of 570 "Taken the test later so I had more time to study after classes were done.” –Score of 487


What Else? COMLEX-USA Level 1 Student Survey also included: • Percent of lectures attended • Percent working (hours included in inc. of 10) • Specialty Choice • USMLE scheduling vs. COMLEX • USMLE scores • Requirements of COM/SOMs to take COMLEX-USA Level 1


Interested? Contact COSGP for more survey data. • Chelsea Nickolson, OMS-III Medical Education Representative [email protected] -or• Kevin Ku, OMS-IV Research Representative [email protected]


Part 3 – Faculty Perspective Standardized Tests


Part 3 – Faculty Perspective Standardized Tests Roadmap - Where can you find it? Test Blueprint Table of Specifications Bulletin of Information www.nbome.org


Part 3 – Faculty Perspective Standardized Tests Roadmap – How does it help? What you will see When you need to be there How you should get there Why it’s important


Part 3 – Faculty Perspective Standardized Tests Roadmap – Greatest Utility? What you will see When you need to be there How you should get there Why it’s important

Content

Context


Part 3 – Faculty Perspective Standardized Tests Content and Context What you study How you study

Determines your score!!


MBTI and COMLEX Scores

Sefcik, Prerost & Arbet, JAOA 2009


Importance of Vignette Examinees with Examinees with Higher Scores Lower Scores No Vignette

99%

Short Vignette

98%

Long Vignette

98%

http://www.nbme.org/pdf/itemwriting_2003/2003iwgwhole.pdf


Importance of Vignette Examinees with Examinees with Higher Scores Lower Scores No Vignette

99%

90%

Short Vignette

98%

82%

Long Vignette

98%

66%

http://www.nbme.org/pdf/itemwriting_2003/2003iwgwhole.pdf


Standardized Tests Stimulus

Content = What Rehearsal Techniques

Facilitation

Inadequate because SAME Context ~ 30% Outcome


Standardized Tests Stimulus

New Context ~ 70%

Stimulus*

Stimulus^

Metacognition

A

Outcome B

C


Standardized Tests Metacognition = Thinking about Thinking How to study? Associations Retrieval


Standardized Tests More than content! Study with context in mind!! Don’t skim / Strive to Clarify Avoid - Illusion of Competence Annotate / Summarize Create your own questions Practice Recall Study with Peers (with a PAL) Be aware of your MBTI type / impact


Take-Home: Standardized Tests Content Blueprint

Items Skills

ST Timed Scoring Guessing

Test-Wise Test-Takers: First Step in Preparing

SOAR R E S O U R C E S

Storage Organize Selection Attention Encoding Associate

Jairam & Kiewra (2009)


Thank you! Are there some questions?

Preparing for Licensure Examinations - American Association of

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