Exam Intelligence

My friend Tash showed me a neat little trick. Some of you probably do this anyway…

Take a sheet of A4, and divide it up into sections for History and Examination, Investigations, Bloods, Drugs, Main Problems and Implications, and if you have time add information about your possible anaesthetic technique.

Use this when going through any practice long case viva, so that you get used to the layout, and it becomes a bit like the Mersey technique for SAQs, where you do it the same way often enough you don’t get frightened of it.

When Tash showed me this I remarked that it seemed to be remarkably similar to the front side of the anaesthetic charts where I work…

For an example (obviously created in Paint):

Why do this? Well, it keeps everything neat and organised, and means you can easily refer back to your information “at a glance”.

I’m afraid I don’t have any magic answers on how to succeed in the exam, other than, “Study Hard”, “Practice Often” and “Study Some More”.

The thing is, that “Studying” is one of those ill-defined things that I say “I’m going to study”, but actually I’m not sure what I mean, and that’s what’s held me back, I think, from getting on with some proper work.

Now I hate “drawing up a studying plan” (or “study plan”, if you like), and I’ve never done that. What I do, however, is decide what it is I hope to learn by the end of my session of “studying”, whatever length of time that may be.

This morning I decided I was going to learn about principles of anaesthetising patients with cardiovascular disease, including hypertension, abnormal ECGs, valve disease, and congenital heart disease. That sounds like a big topic, and it is in some ways. However, by grouping it all together under the “Cardiovascular Diseases” heading, and not spreading them out over a few days, I felt I was better able to integrate the information. Whether it’s gone in for good or not is another question!

Let me explain a bit more: because I had in my mind to learn about CVS disease and the impact on anaesthesia/anaesthetic technique, I had a peg to hang things on. If I then read about some CVS, some renal, some hepatic, and then came back tomorrow to read about some more CVS, it would be kind of jumbled up. Comprende? Instead, because I read all about it in one go, I was able to take ideas from one bit and integrate them with another bit and it all makes (more) sense.

Anyway, that’s what I mostly do, try and have an idea of what it is I want to learn by the end of the session, rather than generically “learning something, anything!”

I did spend about one and a half hours with one of my friends doing some viva voce practice, but I can’t say I felt very positive at the end of it. I would like to excuse myself by saying I have just finished 5 nights, but that doesn’t really make me feel much better…..

One of the things that came out of the last 7 days spent doing an SAQ and MCQs every day for for a total of about 80 SAQs and about 150 MCQs. One of the benefits has been from marking those SAQs ourselves, against an “ideal answer” sheet.

I actually tried quite hard to give credit for some answers that were difficult to read, but it really was frustrating. And that’s what you want to avoid the examiner feeling to get maximum marks.

Here is a much nicer answer to mark than some of my first attempts.

Note the open spaces, capitalisation and clean underlining of “MANAGEMENT” on the right, and compare with the “Blood glucose” sub-point of “Metabolic derangement” closely followed by the “Malnutrition” sub-heading, and see how different it appears.

For comparison, here is a bad layout in an answer about venous air embolism.

If you want to learn more about how to do this, then you need to go on one of Dr David Gray’s Courses in Liverpool. There is NO substitute for the stress you go through on the course, such that by the time you get to the exam it will worry you less. It is, of course, done in a safe environment, and no trainees came to any physical harm except exhaustion.

Please understand that at the request of the organisers and the time and effort they put in, I can’t put more information about the SAQs or MCQs on this page!

With so many things to read I have been reviving my interest in speed reading. I’m not sure it’s working though, although a computer based test tells me my reading speed has gone from 450 to 660 words a minute.
James Shorthouse has elaborated on my list of topics that might come up, with a few suggestions about what would lend itself to being a good SAQ question.

PS: For the princely sum of £7.86 you too can improve your speed reading by buying a program from here. I bought it for a bit of work distraction, but you can plug your own text into the program to read (so you can learn while you practice!) though you do have to tweak it sometimes in Notepad or Wordpad first if you copy and paste from PDF files. And, okay, it has a bit of a…ahem…naff title (Speed Your Read), but hey…

NB: Price was correct at the time of the original blog entry

I have rediscovered mindmaps.
As previously mentioned I struggle with categorisation into lists, but after reading the whole thing about MECE it occurred to me that I used mindmaps when I was revising for the primary, so I’ve started using them again.
It’s actually quite a relief to realise that the reason I used them before is because to me they make sense.
If you have no idea what I’m talking about see here. If that doesn’t make sense (it’s a mind map you’re looking at), then see here or here.
Personally I think they work really well for me, and this morning has all been about Cardiac Anaesthesia, including everything to do with CPB, post-op management and complications. I couldn’t quite fit it all onto one page of A4, but I could have managed it on a sheet of A3 I think.
And that’s with my normal sized writing.