Tag Archive for: NP

Is the Multiple Choice Question Really the Worst?

the word "what" on a pile of question marks for multiple choice question

Most standardized tests, such as the USMLE, PMHNP, PRITE, or ABPN, are in multiple choice question format. The difficulty of MCQ tests seem to vary across individuals. Some love them, some (most?) hate them. There’s a biological reason for this!

Have you noticed that taking a test based on multiple choice questions makes you think differently compared to taking a test based on essays? Multiple choice questions make your brain process information differently. Specifically, multiple choice questions rely on recognition, whereas essay and open ended questions rely on retrieval.

Recognition… plus a little more

When you’re presented with options to answer a question, your brain kicks into recognition mode. It will look for associated information it has seen before to bypass using retrieval (a process that takes more effort). While this is cut and dry, an interesting phenomena can occur in regard to the distractor answers, i.e., the incorrect answers.

You may disregard the incorrect answers because you recognize the correct option, but your brain tucks those incorrect options away. Later, when you are presented with a question related to those answers your brain can spontaneously retrieve those answers more easily because its seen them associated with questions before. Crazy, right? Even if the MCQ test primarily uses recognition, your brain MacGyvers it into a means of storing more information to use later!

Ready to learn more?

Want to boost your brain storage for FREE? Give our question banks a try- FREE- using our Free Trial! Or if you’re ready to take the plunge, check out our Question Banks and find the perfect fit for you! Or, contact us with any questions you have so we can get you on the right path today!

REFERENCES:

Little JL, Frickey EA, Fung AK. The role of retrieval in answering multiple-choice questions. J Exp Psychol Learn Mem Cogn. 2019 Aug;45(8):1473-1485. doi: 10.1037/xlm0000638. Epub 2018 Aug 16. PMID: 30113206.

Time to go back to the ABC’s

Yes, we know you know your ABC’s 🙂 But, sometimes it helps to reinvent the old classics to help us in the here and now. We’ve compiled a quick list of test taking tips that might help you as you prepare for your exams ( using A-E, because those are the letters you’ll see on the exams and maybe that will help keep these in mind!).

ABC blocks

The ABC’s of Test Taking

A Apply basic knowledge

This is the old adage, if you hear hoof beats, don’t assume it’s zebras. When you get your first look at a test question, whether it’s a standard multiple choice or a multiset vignette, the first thing to do is to look for the obvious. Most questions will be testing your basic knowledge and will give you clear signs that point to an answer. Some will be trickier of course, but a good rule of thumb is to dust off Occam’s razor and keep it in mind as you go through the questions. Keep your basic knowledge front and center!

B Block out distractors

Test makers are devious. There, I said it. They intentionally create distractor answers that will try to trick you (so rude). Falling back on the letter A, keep your basic knowledge in mind and then block out the answers you see off the bat as incorrect. For example, you might be reading a question about someone who is lethargic, has a lack of appetite, low mood, and disrupted sleep. Answer options could be Bipolar I, General Anxiety, Depression, PMDD, or Substance Withdrawal. Now, some of these conditions do in fact share the listed symptoms. But there’s missing information that would be required to make those answers the BEST answer.

Bipolar I would require symptoms of mania; GAD has other hallmark symptoms such as feelings of dread/worry that they cannot control; PMDD is cyclical around menstrual cycles in females; substance withdrawal requires mention of something that would cause the withdrawal. The distractors are there to make you second guess, so if one pops out as the best one, chances are it probably is!

C Check the question stem again

Well, maybe the distractors did a good job and now you can’t get passed it. Go back and find the question stem again. What is the question asking? Does it give the information you would NEED to make the other answer fit, or are you banging a square peg into a round hole? While the test makers are tricky, they aren’t totally evil. They will give you all the information you need with minimal need to fill in the blanks.

D Don’t over think it!

Ok, we got through the distractors and now we have our answer, Depression! Makes sense, fits the symptoms…wait, doesn’t it need a time frame to make a diagnosis? What if it’s none of these answers and actually something like Dysthymia? Or– stop. Stop over thinking it. Again, this is the job of the distractors to make you start thinking in circles. If the answer fits the information given in the best way, move on to the next question.

E Every little bit helps

You get about one minute per question on the exams, so you want to crank out as many answers as possible. And, most exams don’t “penalize” wrong answers, they just add up your correct ones. Leaving answers blanks and guessing and getting it wrong will do the same thing to your score. But, guessing might also get you one right! So if you need to stab a guess at one, DO IT because there’s a chance you could get it right!

Want to give this method a shot? Try our Free Trial and see how well it pans out. We’d love to hear from you, and you can Contact us with any questions you have or to let us know if these tips helped you or not!

Clinical Vignettes and How to Ace Them

tangled rope representing vignettes

What are clinical vignettes?

Clinical vignettes are a huge portion of most board exams. They present a scenario to the reader which includes key information they will need to answer a series of questions.

These questions may be syndrome related to identify a condition the case patient is being presented with; they may be symptom related to determine a symptom of a given condition based on the patient’s given history; or they may be treatment related to decide the best course of action for treatment of a given condition. Really, the sky is the limit when it comes to these tricky questions.

Vignettes are helpful learning tools. They hone in on your critical thinking, they test your attention to detail, and they provide a more realistic experience of how to discern information you’re given from a patient to make the best choices. Sometimes they can seem like a giant, tangled mess. Here’s how to untangle it and get started!

Where to start?

Let’s use an example (straight from our question banks!):

Matt is a 13-year-old patient who is brought to see you because of behavioral problems. His parents report that in the last year Matt has had four separate occasions of intense aggression resulting in physical violence. The outbursts do not last long, typically abating within 20 minutes. The behavior is not in character for Matt and do not seem precipitated by a specifically intense trigger. In one instance he was unable to go to a friend’s house; he began screaming and hitting walls which lead to his hands becoming badly bruised. His outbursts are causing significant distress to his family, who are becoming more and more apprehensive of him harming them or himself. There have not been any major life events in the last year, and he is not diagnosed with any existing medical or mental conditions.

Following this, you are presented with question such as: “What is the likely diagnosis?” or “What prognostic factors could have increased the likelihood of Matt developing this condition?

Break it down

The first thing to do is look for key demographic and symptom information. In this vignette, we have an adolescent patient who is male. The vignette also tells us right away that he has behavioral issues. Knowing this narrows down the possibilities. Occam’s razor is true for most cases; you wouldn’t assume a 13-year-old is dealing with frontotemporal dementia for his behavior problems!

Next, look for symptoms ranges. This vignette tells us he’s been experiencing issues for the last year. This is important to know if the symptoms are a new, acute experience or something that has been persisting. It also helps as most diagnoses have requirements on how long symptoms must be present for.

Then, look for the 4 D’s: deviance, distress, dysfunction, and danger. Do the behaviors being presented fit into these criteria? Or is the patient experiencing sub-clinical symptoms with poor coping skills?

Process of Elimination, Vignettes style

Clinical vignettes are almost always multiple choice questions. You’ll be given five or more answer choices with each question and must choose the best option(s). Sometimes there’s more than one answer! Using our example above of “What is the likely diagnosis?“, you may be given answer options of:

A Oppositional defiant disorder
B Intermittent Explosive disorder
C Conduct disorder
D Disruptive Mood Dysregulation disorder
E Antisocial personality disorder

Least likely choices:

Now we need to look at each answer, and applying Occam’s razor, eliminate the least likely choices. Conduct disorder (choice C) does not match the presenting case as Matt does not show persistent disregard for other people or animals, deceitfulness or theft, or serious violation of rules. He does show intense aggression and destruction of property, but these are in brief occurrences and not a chronic issue.

Moving on to Disruptive mood dysregulation disorder (choice D), it also does not fit this scenario as it also requires the patient to have a persistent, irritable, negative mood most of the day every day; further, it cannot be diagnosed unless the behavior began before the age of 10. Matt’s parents have reported that this behavior has only been present for the last year in isolated incidents starting when Matt was 12.

Let’s look at Antisocial personality disorder (choice E). This condition cannot be diagnosed until the patient is 18, with specific disregard for the rights of others being present from the age of 15. Kick that one out.

And Oppositional defiant disorder (choice A). This is recognizable by persistent angry, irritable, vindictive, and argumentative behavior that is noticeable at least once a week for at least six months for Matt’s current age (attention to detail!).

Most likely choice:

Matt is presenting with symptoms that best match intermittent explosive disorder (choice B). His behavioral problems have only arisen in the last year with isolated incidents of intense, aggressive outbursts. The events are not precipitated by major life events or stressors, and the reaction is grossly disproportionate to the triggering incident.

Timing is Everything

The hardest part of mastering vignettes is being able to do them within time constraints. Generally, a board exam allows about 1 minute per question on the exam. 60 seconds is not a lot of time to gather all the information, discern what is valid or not, and eliminate the least likely options.

So what is the secret? The true key is practice, practice, practice. You know your DSM conditions, you know their criteria. You just have to practice the mechanics of gathering information and making critical choices from it. And what better way to do that than to give our clinical vignettes a try- totally FREE? – using our Free Trial!

We tailor each bank to the type of test you’re taking, whether that is Nurse Practitioner Mental Health Certification, ABPN, USMLE, or PRITE. You can take these practice exams over and over again until you get the hang of it. You can use a practice mode that doesn’t penalize for time, or you can use the timed mode that mimics the actual exam.

We want to help you MASTER clinical vignettes. They’re the part of exams most people do the worst on. Let’s tackle this and make it your strongest section! If you like what you see on the trial, check out our Question Banks and find the best option for you! Or, contact us with any questions you have so we can get you on the right path today!

Test Anxiety and How to Manage It!

Test Anxiety and Performance

Most people know that chronic or acute anxiety has negative impacts on performance. This is particularly true for academic performance in the form of test anxiety. But, what is more stressful than going in to take an exam that will determine the rest of your career? Obviously this goes without saying that exams and anxiety go hand in hand.

However, some people are impacted by this more than others. There are a few factors that influence this, and if you fall into one of these categories, we hope we can offer some help to get you through your next exam with flying colors!

Glasses on notebook from test anxiety

Working memory can amplify the effects of test anxiety

Everyone feels the effects of anxiety. It makes it harder to concentrate, bring information to mind, and sucks your motivation. But there are some lucky individuals that feel these effects harder than others.

Working memory (WM) capacity, or the amount of information you’re able to hold in mind at a given time, differs across individuals. The more WM capacity you have, the more easily you can hold bits of information at the front of your mind and retrieve that information for a task at hand. The lower your WM capacity, the harder this is. This capacity varies from person to person.

People with low WM have increased effects of anxiety on test performance. The relationship seems to be: anxiety interrupts WM (which is already having a hard time), which in turn effects retrieval of additional information. Further, the anxiety the person is feeling diverts attention from the task at hand to worrying about their performance. This results in reduced performance which is not reflective of the person’s true ability!

Distress load

Another factor that can make test anxiety worse some compared to others is total distress their experiencing. Regardless of their working memory, if a person is experiencing high levels of distress, they will under perform on academic tests. High stress shuts down your prefrontal cortex which interrupts executive functioning and critical thinking. This leads to higher anxiety, reduced attention, and thus lower scores.

If you’re experiencing extraneous factors in your life that are causing you significant distress, this may have detrimental effects on your academic strivings.

So we know these different things hurt some people more than others, but what can we do about it?

Social Support

As we all know, people are social creatures. Studies have shown that increases in social support negatively predict test anxiety. So what does this mean? Stop studying for a hot minute and go chill with your friends! (What, a test prep site is telling me to NOT study??- yes!) The more we experience social support, the less likely we are to experience test anxiety. Does this mean it magically disappears? Unfortunately, no. But, it can help mitigate the amount you experience!

Self-Esteem

Self-concept, self-esteem, call it what you want. Individuals that have a greater capacity for self-esteem or self-care tend to have greater academic achievement, and this can reduce the effects of anxiety you experience. This isn’t a one size fits all concept. Some people come in knowing they’re the cat’s pajamas (and let’s be real, you really are 😉 ), but others need some help seeing the value they bring to the table just by being themselves.

Not to be repetitive, but if you fall into the second category, try getting around some people that help boost you up! If this isn’t a friend or other trusted person, sometimes seeing a counselor can help shift our perspectives on ourselves just a bit. And clearly the implications of doing this will reap reward!

Studying skills…what about those?

One last interesting thing about those of us that experience higher levels of test anxiety is we generally have GOOD study skills! So know that you have the tools to accomplish what you’re aiming for. You aren’t less intelligent even if your test scores come out lower than you know you can do. We know that, too.

At the end of the day, text anxiety can’t be totally dispersed as much as we’d like it to be. But, if you know you’re someone prone to experiencing it, we hope we dropped a few tidbits to help you get through your next round of exams with a little less stress! Want some extra practice? Try our question banks – FREE- using our Free Trial! Or if you’re ready to take the plunge, check out our Question Banks and find the best option for you! Or, contact us with any questions you have so we can get you on the right path today!

REFERENCES: Hyseni Duraku, Z., & Hoxha, L. (2018). Self-esteem, study skills, self-concept, social support, psychological distress, and coping mechanism effects on test anxiety and academic performance. Health psychology open5(2), 2055102918799963.

Matthews, G., Wohleber, R. W., & Lin, J. (2020). Stress, skilled performance, and expertise: Overload and beyond.

Avoiding Burnout at the End of the Year

We’re almost to the finish line of 2022! This time of year is rife with the possibilities of BURNOUT. Are you starting to feel the creeping feelings of exhaustion, alienation, or reduced performance? Or just feeling like you’re ready to be DONE with this phase? Burnout is common, especially among care providers, but it doesn’t have to take over your Holiday season. We have tips and tricks on how to avoid the end of year burnout so you can finish out strong.

man lying on road with burnout marks

What is burnout and why are we talking about this?

First, what exactly is burnout, and what causes it? This might seem like a silly question. But it’s worth talking about for a second. According to Mayo Clinic, burnout is “…a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity”. In other words, you’ve been doing the same (or similar enough) things for a long time and you’ve reached your capacity to keep doing it at the same performance level.

This is important to talk about because burnout and depression share a lot of similar symptoms. And while you might be experiencing the dragging feeling of typical tiredness, late October through end of February are the months when some folks tend to face the worst symptoms of depression as well. Why? A few reasons are the culprit: Seasonal Affective Disorder (SAD), spurred by the lack of sunshine and being cooped up inside, holidays spent without family or friends (whether due to a death or alienation), or inversely holidays spent WITH family or friends that are not safe to be around can be the top of the list.

Depression and burnout can feel the same, except for a few key differences. Burnout almost always is focused around performance of a task, such as school or a job or even long term care of a loved one. You feel tired, cynical, irritable, emotionally numb, have trouble concentrating or getting going, or gastrointestinal issues. Depression involves all of these, but also low self esteem, hopelessness, and/or suicidal ideation. For your own wellbeing, it’s essential to distinguish between these two things.

If you are experiencing thoughts of harming yourself or others please reach out for help. Call 988 to contact the Suicide and Crisis Lifeline for 24/7 free access to support.

Let’s talk about how to help!

Ok, this is easier said than done (as most things are). You’re experiencing some burnout, whether that is from finals, rotations, school demands, or your current work position. We have some ideas on how to help you get through the next few weeks or months:

  • Get support. This can’t be stressed enough. Grab a cup of coffee with a friend, call your mom/therapist/other trusted person, or commiserate with your cohort. People are social beings and we need to be in community with others to thrive. You will be amazed how much better you’ll feel just by venting for an hour to another person!
  • Journal. A great tool for monitoring your stress and coping levels is by journaling for a few minutes every day. The act of expelling all the negative feelings you have out of yourself is something quick (more or less), easy, and free. It’s also something that can create a sense of autonomy over your stress. Writing things out allows you to evaluate and mull things over in a different way that can lead to more creative solutions or coping!
  • Self-care stress management. Again, easier said than done, but will reap benefits if you implement it. This looks like aerobic exercise, yoga, mindfulness meditation, or a hobby that relaxes you (art, crafting, reading, bubble baths, sitting under a tree…the options are endless!). Carve out the time for YOU and no one else that has nothing to do with any of the things stressing you out.
  • If possible, do something that actively makes your situation better. How? If you’re a student prepping for a board exam or needing help with the school year, give our question banks a try- FREE- using our Free Trial! Or, contact us about our tutoring options!

REF: Depression: What is burnout? Informed Health Online. https://www.informedhealth.org/what-is-burnout.html. Accessed May 13, 2021

Swenson S, Shanafelt T. Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace. Oxford University Press; 2020.

Failure is a Fearsome Thing. Here’s How to Combat It.

Didn’t make the score you hoped? While it sure feels like a failure, here’s why it isn’t the end of your journey.

Man holding sign that says "failure"

Failure Does Not Define You!

When you spend so much time (and money!) preparing for a big test, failing can feel like a literal slap in the face. Picture this: you’ve been studying like crazy, going through exam prep books, watching lectures, taking practice exams, and the week of your test you get a cold. Then your car breaks down. And it’s finals week. You do your best, but still come out short of what you were aiming for.

Quitting time? Sure feels like it. You probably feel like an imposter, like anyone else “would have” done better (when in reality, a healthy and non-distracted you would have done better, too!). You start to second guess if you should even be trying to do this field, or if you should opt for something different. This is the time to take a step back.

Did that short score feel like a punch in the gut? Absolutely. Does it mean you are a failure in everything you do? Of course not! Take a minute and think of all the amazing accomplishments you’ve made to get this far. Whether that be post-secondary education, publications, presentations, or any of the other hundred or so responsibilities you’ve smashed in the last few years. You. Are. Doing. A. Great. Job.

Who, Me?

Yes, you! Some days we will fall short and that is terrifying. But it also should be inspiring when you look back and see how far you’ve come from where you started. It is too easy to get wrapped up in all the prepping and studying that our very identities become enmeshed in the outcome of something like a psychiatry board exam. While they are important and definitely will be a requirement to pursue this field, sometimes it’s worth stepping back and remembering who YOU are is more than the number that test will spit out.

We all need this at times. Even when the board exams are behind you, different things will crop up in your career that will leave you reeling and questioning everything. No one is perfect, and no one can predict what life will throw at you. All you can do is evaluate the situation at hand and….

And… And What??

Study, work hard, and do your best! After you’ve taken your day or two to breathe, dive right back in. Is that first score a disappointment? Yep. But that score does not mean YOU are a disappointment. It means you get another opportunity to give it your best shot and come in swinging. You can also check out our previous blog on what to do after you’ve failed an exam for more direction on where to go next!

Maybe give a question bank a shot 😉 (see our free trial here!)

Introducing: Observership Programs powered by My Psych Board

I bet you didn’t know we offered Observership programs right here at My Psych Board!

Yes, that’s right… we are your one-stop-shop place for all your studying needs, prep, and learning (and that’s not going to change)… We’re much more than your average Board Exam prep Q-Banks. But wait, we have much more to offer you. 

We can help get YOU into an Observership program which is an essential part of your career journey.

So what is an Observership & Why do residents need this?

Imagine an Observership as a Medical Internship that can be done both in person and via Telehealth to give residents practical, hands-on experience.

As part of this experience, you will be required to watch and listen to patient histories, physical examinations, procedures, surgeries, outpatient appointments, teaching rounds, and educational conferences. The entire experience is generally longer than a day, but no longer than 4 weeks!

The importance of this can not be overlooked. 

Most students will need to cover Observership hours to complete their residency.

Now of course this may not be required in your field so if you’re unsure if you need this (or just want to be safe) just send us a DM via our Instagram (@MyPsychBoard), Email, or drop us a call so we can point YOU in the right direction.

Ready to get started? Contact us today! We can’t wait to travel with you along your journey to passing your Psychiatric Board Exams!

How to create study habits that are long lasting!

Your study habits can make or break your success in school.

If you’re already struggling with how to create long-lasting study habits, have no fear… you’re not alone! May students go through the same issues as you.

The solution for long-lasting study habits is straightforward!

First, find a place to study regularly, consistency is key!

You might find that having a set time and place in which you study helps keep your motivation high as well. Even if you’re a procrastinator and tend to put it off until the last minute, finding a place that’s comfortable for you will make all the difference.

Next up: keep track of deadlines and important dates. If you know what’s coming up then you can plan accordingly and make sure not to procrastinate!

Once you’ve got those two things squared away, you’ll want to start thinking about how you study best. — Maybe it’s listening to music while reading; maybe it’s taking notes on index cards; maybe it’s something else entirely! Whatever works for you is great! Just remember: what works for someone else might not work for you.

After all your base preparation, don’t stuff & cram for your exams!

Instead, just relax and get ready for what’s ahead by practicing some relaxation techniques like deep breathing or meditation. You’ll be surprised how effective these methods can be at helping calm down before big tests or projects!

Once you’re relaxed and have taken time for your mental health jump back into it! Throughout the weeks set aside time to quiz yourself with appropriate materials or question banks to ensure you’re retaining the information!

Still, feeling uneasy or overwhelmed? Contact us and we can help YOU pass your boards with ease!

Studying Tips Broken Down: Set yourself up for success!

Time to get back to studying… wow… it seems like just yesterday the summer was just kicking off!

Now it’s time to head back to school, so naturally, we’ve received some DMs asking “How can I make the most of the upcoming school year?”.

Going back to school can seem like an overwhelming time and it can be, but we’ve put together a few studying tips that should help you excel in your learning.

Our Top Five Tips!

1️⃣ Get Organized…

Get all your study materials together, ensure you know your new schedule, and plan your time properly. Take a look at each class; What do you need? What do you already have?

2️⃣ Be Active In Your Learning.

Don’t just follow your current curriculum. Seek out other experiences and knowledge whether you’re in a group studying, participating in volunteer labs/programs/research groups, and much more. You can gain more knowledge and experience this way!

3️⃣ Study, Study, Study — but with others!

Studying with others can improve your memory recall, provide other points of view, and give you a great trusted group whom you can make memories with outside of just staying. Since you’re all going through the same experiences together it can help ease the stress. You could even utilize various question banks and tools to make the most of the study sessions!

4️⃣ Use Your Time Wisely

Just because others are going out every night doesn’t mean you need to… you can still have a solid social life AND go to school. Write down and prioritize everything you need to do. Ensure you have built a solid routine, and get what you need to do, but also make sure you are taking time to have fun too (which brings us to our next section.)

5️⃣ Take Care Of Your Mental Health!!!

This is last but certainly NOT least. We’ve said it before and we will keep saying it. Take care of yourself and your mental health. You need to ensure you aren’t pushing yourself too far. Find things and activities which help you relax. School is not forever so take everything one step at a time. Use your support group/study group we mentioned in point 3.

Need some additional tips or a tutor? Contact us today!

Who is My Psych Board?

My Psych Board is a board review website created by Dr. Abdel, MD, MBB. CH., founder and CEO of Westlake Brain Health clinic in Cleveland, OH. This program offers access to unique courses and question banks to prepare residents and medical students for the American Board of Psychiatry and Neurology (ABPN) Psychiatry Certification Exam, Psychiatry Resident In-Training Examination, United States Medical Licensing board examination, and Nurse Practitioner examination. Each question bank is specifically tailored to the required difficulty and type of questions expected for the different board exams. New questions are continually being added to the question banks, ensuring the most current and up-to-date information is being made available.

My Psych Board is created by experts in the field and covers all the topics you need to master in order to pass your board-certifying exams. Feedback is given immediately in Practice Mode as questions are answered, including in-depth explanations that accompany each question for both correct and incorrect answer options. Additionally, students have the option of accessing a one-time phone call with Dr. Abdel to discuss their best studying strategies and one-on-one tutoring to help them gain maximum preparation. My Psych Board is customer oriented; we take your feedback seriously and are always looking for ways to improve the user experience!