Try this strategy if you’re struggling with test-taking in med school or on the Boards
We talk a lot about it. So, most people who follow our content know that a best practice in working on medical boards-style questions is to begin by reading the prompt first. (If you’re new here – welcome! The prompt is the final sentence in the passage – the one that asks the question you’re trying to answer.) To set yourself up to effectively read the rest of the passage, pay attention to the prompt. After that, we all know we are supposed to go and read the question and look for potential clues to help us answer it. And then on to the answers to see how those clues fit, right? Well… no. There is an oft-overlooked and frequently forgotten step that, in our test-testing, slips in between reading the passage and looking at the answers. We call this the status check.
The Status Check
I very deliberately define status check for my clients as: “Adding all of our gathered clues together in the context of the prompt to see what we know and what we don’t know prior to looking at answers.”
Sounds pretty straightforward, but let’s break this definition down and see if we can tease out a bit of crucial nuance.
- “Adding all of our gathered clues together” I use this wording because I often see clients generate their status check, thinking only of one juicy clue instead of taking ALL of our carefully selected clues and adding those together. This is used frequently because one clue sparks a strong association with a specific diagnosis, and we get excited about that. And if we roll those other clues in, they don’t fit the theory we’re working toward, so it’s easier to sweep those other clues under the rug. This is incredibly dangerous because we are now cherry-picking our clues to fit our theory instead of basing our theory on all of the best available evidence. This is similar to the old folktale of the blind man touching an elephant’s tail and becoming convinced he’s found a rope rather than a pachyderm.
- “…in the context of the prompt,” It’s great to check back in with our valuable clues from the passage and see what they add up to. If this were your status check, I’d give you a high five. But if you want a high TEN, then you want to go one step further and see what those add up to in the context of the prompt. Let me give you an example prompt: “What is the next best step in managing this patient?” I’ll often have clients read through the passage, identify important diagnostic clues, and land on a diagnosis (let’s say, pulmonary edema, for example). But then they stop short of asking themselves, “Given what’s been done already and where the patient is in the course of their pulmonary edema, what do I know about the next best step in management?” We fail to anchor ourselves in our knowledge regarding the prompt. This leads to our having a good —but not great — status check. Let’s all aspire to greatness, okay?!
- “…to see what we know and don’t know” So, it sounds like I’m asking you to PREDICT the answer. Well, if you’ve hung around STATMed HQ for any time, you know that predicting is a four-letter word around here. Putting pressure on yourself to be able to predict the answers to board-style questions is, at best, silly and useless and, at worst, destructive to good test-taking and good self-esteem. What we are asking ourselves during status check is NOT “What is the answer?” but rather “What do I know about what is going on with this patient?” Now, it may be that I know a ton! I may be pretty dang sure that the patient has pulmonary edema, that it’s acute and severe and that it requires oxygen right away. Or maybe not. Maybe I know that there are respiratory issues and that there is excess fluid. Or maybe not even that. Maybe all I know is that this patient is in acute distress and is short of breath, and it’s not asthma. And any of those are fine. Let me repeat that because it’s important: any of those would be fine status checks. A solid status check may be anywhere on the spectrum from “I think I know exactly what’s going on here” all the way to “I really don’t know, but I can rule some things out or say some very general things.” The mark of a great status check is not how specific it is but rather how HONEST it is. We want the most accurate possible statement of what you know and what you don’t going into the answer set. If you don’t know what’s going on in the question, that’s fine, but we are way better off acknowledging that than forcing a theory in because we’re anxious to have a theory.
- “…prior to looking at answers.” This one sounds pretty obvious, and it is, but that doesn’t mean that it won’t bear repeating. All of this happens before we peek at the answer set. It may be a bit of an odd analogy, but think of it like this: when you are reading the prompt and the passage, it’s like you’re out in the middle of a dodgeball court, getting pelted with potential clues and input from every side, and you’re trying to catch the most vital ones to the question. You can’t catch them all, but maybe you can get three good ones. Then you leave the chaos and turmoil of the court and go back into your quiet office, shut the door behind you, and lay those dodgeballs (clues) on your desk to see what you can make of them. This is your moment of quiet reflection, gathering your thoughts and grounding yourself in your knowledge before you venture into the answer set where even more dodgeballs (this time, answer options) are getting hurled at you. I told you it was a strange analogy. But I stand by the message, which is that it’s necessary to take a few quiet moments in the hubbub of working boards-style questions to check in with your knowledge. That’s what the status check is all about.
If you’ve gotten this far, congratulations — you are nerding out at an extreme level on test-taking process. I’d be hard-pressed to point to any one step in the STATMed test-taking methodology as the “most important,” but it’s not hard for me to point to the most underrated and the one that can land you more questions: the humble status check.
Interested in learning more about test-taking and boards strategy? Check out the Boards Test-taking Workshop today!