#microbiology study

Final cover choice for The Small Guide to Small Things.

This is the one I went with. What do you think? It’s due out soon, currently collating reviews!

Twitter @WarholScience

Official ASM Conference for Undergraduate Educators meeting sponsor

Once again, we are the official conference bag sponsor for the ASM CUE meeting in Austin. I hope everyone has a great time and orders many copies of The Small Guide to Small Things!

Twitter: @WarholScience

Get the book: https://tinyurl.com/Warhol-Small-Guide

People keep asking me how I got a 254 on the USMLE. After all, I'm not a particularly smart person and when I got junior AOA, my classmates Let out a communal gasp.  What was my secret? I knew how to study intelligently. Starting my M1 year, I employed a few fundamentals of learning theory, I had learned in Psychology undergrad (and my mom said it was a useless degree! p'shaw!).  What did I do? Read on:

First of all, don't me fooled by blogs and USMLEforums telling you how to organize your time.  Look inward.  Studying is such a personal thing, that only you can decide what works for you. Just ask yourself these questions:

QUESTION 1. What is my personal learning style: Auditory, Visual, or Finesthetic?

First of all, I hate auditory learners.  They can sit in a lecture and remember every word. They insist on group study sessions, they actually use the class podcasts, and they swear by Guillon audio files: "Don't you have those yet? How can you NOT have them?" Sigh. The kinesthetic (or tactile) learners uses hands-on learning and dives head-first into the anatomy lab. As for me, I am a visual learner. Draw me a mind map and I will never forget the information. Never. Visual learners are awesome. I love us. I am a pure visual learner, but many people are a combo of one of these three styles. 

QUESTION 2. How much time can I realistically spend in a day studying without driving myself nuts?

 The brain has its limits. My limit is 6 hours - split any way. I can do 4 in morning, 2 in afternoon, or 2 hours in the morning, afternoon, and evening. After that, my attention wanes, and I start to YouTube Twilight trailers  If you were to be honest with yourself, how many good hours of studying can you really do? Often people overestimate their brain's attention span and this leaves them staring blankly at the computer, wasting many, many hours pretending to study. Like those people who "stay at home to study" on Friday nights. they don't study. Their brain forces them to creep Facebook for pictures, living vicariously through their friends who have chosen to have lives.  

QUESTION 3. The big question: What study materials will I use?

If you think that in the week before the USMLE, you are going to go back to your textbooks and finally spend some good quality time with the Kreb's cycle, you are nutso. Now is the time for word-associations, not prose.  There's no question here: Use First aid for the Boards. If you memorize every word of that book, you will do well. Augment First Aid with two other more books: (1) Microbiology Made Ridiculously Simple, and (2) BRS Pathology. Then pick a question bank (USMLE World or Qbank). The rumor is that Qbank is superior for step 1, but it doesn't matter.

QUESTION 4. Don't just read information... VIOLENTLY SHOVE information into memory. How do I do that?

There is no sense spending time studying unless you are using techniques to help improve memory retention. I like the three-exposure technique:

     Exposure #1: Read and highlight First Aid

     Exposure #2: Study in-depth. Within 24 hours of your first exposure, shove that info into memory by forming associations using graphs (visual learners), rehearsing flashcards (auditory learners), and manipulating the information (kinesthetic learners) until every piece of info is connected to another (i.e. giardia causes fatty diarrhea... and so does pancreatic insufficiency... how interesting).

     Exposure #3: Test retention with practice questions. People who pontificate over question should aim for completing half of a question bank. People whose strategy is speed, may complete 80% or more. Keep track of the topics in which you are performing poorly. And then try these retention techniques: 

(1) Review these topics more in-depth, seeking primary resources... now is the time for the book chapter.

(2) Reorganize your study material (i.e. put all of the causes of diarrhea together and compare them in a graph),

(3) Repetition, repetition, repetition.

  QUESTION 5. How should I lay out my schedule for the weeks leading up to the USMLE?

Make a list of all the topics you need to cover - basically this is the table of contents in First Aid. Then spend a day, clocking your hours and doing some math.  If it takes you 2 minutes to read a page from First Aid, and the Cardiology chapter is a 30-pager it will take an hour. Double that time for in-depth learning (3 hours total). Then time how long it takes you to do 50 questions... or even 25 if you haven't built up your Q&A stamina. If there are 300 questions in Qbank and you are a pontificator, aim for 150. I spent 3 hours doing and reviewing 50 questions. So I can study for 6 hours a day, which means cardiology will take me 2 days: one hour for Exposure #1, two hours for Exposure #2, and 9 hours for 150 questions at 3 hrs/50 Qs... that's twelve hours. Using this information, estimate a weekly study schedule. Plus give yourself 1.5 bonus days a week for those topics that you needed some extra time on. 

Yes, the math is irritating, but it is worth it to have an organized and realistic idea of how the next few weeks will be and if you are giving yourself enough time before the exam.  

Feel free to use your scores from both available NBME practice exams to readjust your schedule. If you are doing well on a topic, stop studying it for goodness sakes. Use that extra time on topics on which you are not performing as well. For instance, if you are scoring over 70% on the question bank questions, it is time to move on.

 Viola! A personalized schedule. Most importantly study to remember and use your own study-style.

The first thing to remember when trying to answer a question on the nclex cd is that it isn’t a test of your ability to recall facts. You need to first determine what the question is asking and then be able to think through a problem or situation that the question presents to you. Background information that isn’t related to the question will not be useful to you.

Critical thinking is the key to answering the nclex study test questions. Thinking critically as a nurse involves observation, deciding what’s important, recognizing patterns and relationships, identifying the problem, being able to apply knowledge to a number of different situations, discriminating between different answers, and evaluating based on established criteria.

Let’s begin at the beginning. You have to decide what the question is asking first and then eliminate answers. This usually means that you need to determine what the best answer is, as some of the distracters are also be true. In order to analyze and interpret just what the question is asking, you should put the questions into your own words.

Number One, read each word slowly as you decipher the question. If you skim, thinking about getting to the end of the question, you may skip over important meanings.

Number Two, look for clues in the actual wording of the stem. Words like, most, best, first, and initial are telling you to establish priorities. Phrases like, further teaching is necessary are telling you that the answer will have incorrect information. The phrase “client understands the teaching” tells you that the answer will have correct information.

Number Three, you need to reword the stem so that it reads with words that are familiar to your own vernacular and can be answered with a yes or no. You should start with words like what, when, and why.

Number Four, read the answers for clues if you can’t do number three.

Let’s reword the following question for practice:

A six year old girl has a fractured femur and her parents take her to the emergency room. Her parents replied, when asked how the injury happened, that she fell off the couch. During the exam the nurse finds several lesions on her buttock. Which statement would be most appropriate for the nurse to record from her findings?

1) Slowly and carefully read the stem.

2) The adjectives “most appropriate” means that you need to choose the best answer.

3) Using your own words, ask the stem question. “What is the best charting for this situation?”

4) You don’t need to read the answers for clues since you were able to complete step 3.

Over the next several days, you will be receiving additional installments in this exciting and informative series. If you are truly serious about taking control of your future by passing the NCLEX-RN Exam, we hope you will take time to read each installment. In fact, you might consider printing out each installment so you can have them all in one place when you need to refer back to them in the future.

In this, the first installment of the “Crack the NCLEX-RN Code!” mini-eCourse, we’re going to explore ways to “deconstruct” the types of multiple choice questions you’ll see on every page of the exam.

Multiple choice questions have three basic parts to them:

1. The stem contains the situation of the patient; problems and health care needs.

2. A question or incomplete statement that you must answer follows the situation.

3. The three wrong answers are called distracters. The correct answer is what you are looking for.

Distracters will contain some logic according to the stem, but they will not specifically answer the question. They may also be common nursing practices, but not the best ones.

The correct answer is what you must choose and what you must learn to detect by understanding the logic behind nursing care.

For example, an NCLEX-style question must be broken down into its components:

A four-year old girl who has been sexually abused by her father is scheduled for play therapy with a nurse. The nurse knows that the primary goal of play therapy for a four-year old is to…

a. Determine through direct observation of the girl during play what kind of abuse has occurred.

b. Encourage communication since the girl may not have the emotional or intellectual ability to verbally express her perceptions.

c. Assess whether or not she is functioning at the right developmental level.

d. Give the girl the opportunity to show anger and hostility with dolls during play time.

The components of this question are:

Stem – four year old girl, sexually abused by father, scheduled play therapy, primary goal of play therapy for a four year old.

Answer choices –

a) Determine what kind of abuse has occurred. The child might willingly communicate what kind of abuse she’s endured. The nurse should concentrate on the purpose of play therapy and not on the type of abuse. **This is a distracter.**

b) Encourage communication. Children communicate through play and the goal of play therapy is to encourage communication of children by using their own language.

**This is the right answer.**

c) Assess her developmental level. Even though the nurse would probably be able to determine what developmental level the child is functioning at, this is not the main goal of play therapy.

**This is a distracter.**

d) Opportunity to express anger and hostility. Although play therapy does give children the chance to express anger and hostility, it does not exactly address the question because it isn’t the primary goal of play therapy.

**This is a distracter.**

As you can quickly see, there is a method to deconstructing multiple choice questions. If you once found them confusing, you’ll learn there are proven ways to “unpack” them so the answer almost presents itself to you.