1. Effective Study Strategies for the North American Veterinary Licensing Exam (NAVLE ®)
Steven I McLaughlin DVM, MPH, DACVPM

2. “To achieve great things, two things are needed; a plan, and not quite enough time.” Leonard Bernstein

3. A Story
Once upon a time, there was a world called veterinary medicine,
covered in many forests.
One forest was called “Dogs”; another “Pigs” and so on.
In the Dog forest, there were many trees. One tree might be called
“Cardiology” and another called “Endocrinology”.
On that Cardiology tree might be a single leaf called “Dilated
Cardiomyopathy”
One day, a good-hearted but near-sighted vet student wandered into
the Dog forest, and got so engrossed studying a leaf on a single tree
that she got lost, and a big bad wolf called NAVLE® came and ate her The End

4. Today’s talk: North American Veterinary Licensing Exam (NAVLE®)
NAVLE structure, pass rates
Study strategies for NAVLE
Test-taking strategies for NAVLE

5. NAVLE® Structure 360 questions, takes all day Six 60-question blocks
65 minutes per block
~1 minute per question
~10% of questions have images
60 questions not counted during scoring
Breaks
No break once you start a block
45 minutes break-time available between blocks
If finish block early, get extra break time
Reference: NBVME NAVLE FAQs page

6. Worth Remembering on Test Day
Show up 30 minutes early
Must have Scheduling Permit
Must have unexpired government-issued identification ie:
Driver's license or passport-includes both photo and your signature
First, last names on i.d. must exactly match name on Sched. permit
No personal belongings allowed in test room
No calculator, cell phone or digital watch
No food or drink
No backpack, brimmed hats, purse or coat
What is allowed ?
Erasable whiteboard provided for calculations
Some people bring earplugs
Reference: NAVLE® Candidate Bulletin:

7. NAVLE® Structure 70 (23%) Canine: 68 (23%) Feline: 45 (15%) Bovine:
77% of the NAVLE®
70 (23%) Canine:
68 (23%) Feline:
45 (15%) Bovine:
47 (16%) Equine:
17 (6%) Porcine:
10 (3%) Pet Birds:
10 (3%) Public Health and Food Security:
10 (3%) Ovine/Caprine:
10 (3%) Other Small Animals:
6 (2%) Poultry:
3 (1%) Non-Species Specific:
2 (<1%) Cervids
2 (<1%) Camellids
300
Added Fall Added Fall 2011
Reference: 7

8. NAVLE® Pass Rates Fall 2007- Spring 2013
Senior students, AVMA accredited schools
1st attempt pass 92-96% Overall 97-98%
Zuku pass rate = 96-98%
Criterion students (Seniors, 1st attempt AVMA Accredited Veterinary Schools)
Fall 2011 Spr % Pass, 8% fail, ~ 3600 tested, + Ano ~1200 non criterion took test
Fall 2010 Spr % Pass, 5% fail,
Fall 2009 Spr % Pass, 4% fail,
Fall 2008 Spr % Pass, 7% fail,
Fall 2017 Spr % Pass, 8% fail, ~ 2900 tested, + ano ~1200 non-criterion tested
So heck, why study, right?
Reference: NBVME NAVLE® results pages “Criterion students: Seniors, 1st attempt AVMA Accredited Veterinary Schools Fall 2007-Spring 2012 8

9. NAVLE® Pass Rates What do they mean to me?
Pass rates are high because people prepare
No matter what pass rates are for thousands…
Its still you who has to perform on test day
How would you rather spend the next 6 months? Procrastinating and anxious? Or making steady progress?
How would you rather feel on test day? Tuned up and confident? Or sleep-deprived and twitchy?

10. The 3 most effective things you can do
Do practice questions that are as much like the real NAVLE® as possible (~2/3)
Study summary notes with images (~1/3)
Leave 4-5 weeks free before NAVLE® to do test-mode tests and review your notes

11. Summary Notes (and hitting the books) ~1/3 of your time
Why review visual summary notes? (and good visual books)
Faster, more effective than wading through pages of text
Images are like “mental duct tape”
Information sticks to them
Visual summary notes worth their weight in gold in weeks before test
NOTES:  The best approach (which few of us quite achieve...) is to try to finish a broad review 3 weeks before the big test. Along the way you should be summarizing your key topics with notes and giving regular time each study period to doing practice tests. You want your prep to be a routine thing you do through each week, according to a plan, not some spasmodic marathon Saturday study binge.... For the notes, they are best if organized and written by YOU. No notes I could write you or that you might find online are as good as ones where you personally processed and organized the information. It like you have written them in a language that your brain uniquely understands.

12. A picture IS worth a thousand words:
Fluid-filled lungs: Pulmonary edema
“Floating lungs”: Pleural effusion
Images courtesy of Dr. Terri Defrancesco, DVM, ACVIM,

13. Traditional notes: What most notes look like13

14. PRESENTATION AND CLASSIC CASES
What You Want: Visual Summary Notes
PRESENTATION AND CLASSIC CASES 14

15. Visual Summary Notes
TESTS OF CHOICE 15

16. DIFFERENTIAL DIAGNOSIS
Visual Summary Notes
DIFFERENTIAL DIAGNOSIS 16

17. Visual Summary Notes
TREATMENT 17

18. Special Notes Topics: Acid Base Review18

19. Special Notes Topics: Equine Lameness19

20. Coming Soon: Zuku Dynamic FlashNotes™ Like flashcards, with notes!
How would you treat a standing cow with a presumptive diagnosis of listeriosis? 20

21. Recommended books for NAVLE®
Outside a dog, a book is a man’s best friend. Inside a dog, it’s too dark to read Groucho Marx 21

22. Recommended books for NAVLE®
For medicine and disease summaries:
Bovine: *Guide to Bovine Clinics 4th ed.—Pasquini
Equine: *Guide to Equine Clinics 3rd ed.—Pasquini & Woods
Dogs and Cats: *Clinical Veterinary Advisor, Dogs and Cats, 2nd ed. Cote' ed. *Tschauner's Guide to Small Animal Clinics 3rd ed.—Pasquini
Pharmacology: *Plumb’s Veterinary Drug Handbook, 7th edition
The original & a favorite, available as a book or online through VIN
Clinical Pathology: Duncan and Prasse's Clinical Pathology, 5th ed.
35 excellent case studies in appendix.
*Pick of the Litter

23. What if I am not a horse person? (or cow person)
From: Pasquini, Pasquini & Woods, Guide to Equine Clinics, 3rd ed. p. 113 23

24. Practice testing for NAVLE®: ~2/3 of your time
“You don't get ready for a marathon by reading a book about it. You put on your running shoes and run.” Dr. Zuku
Practice testing helps accustom your mind and body to performing in the same way that you will need to do on your test day-it gives you experience with the testing environment and an objective measure of your strong and weak points. It also helps build your expertise at coping effectively with those inevitable questions about which you don't have a ready answer.

25. Multiple choice tricks of the trade
The Good News Correct answer is GUARANTEED to be among the choices
The Bad News You WILL hit questions you don’t know Common mistake: Spending MOST of your time on questions about which you know the LEAST.
Key to success: Train yourself to MAKE CHOICES and then MOVE ON.

26. Multiple choice tricks of the trade
READ the question first (DON’T look at answers)
PREDICT the answer (protects you from distractors)
Is your answer the best of the choices ? If “Yes” SELECT it and move on
Unsure of the correct answer ? ELIMINATE wrong ones, choose from what’s left, and MOVE ON
Half the battle is training your brain and your body how to cope with answering lots of practice questions, and how to cope with the inevitable questions you don't know. Even if you studied full-time from now till test day, you can fully expect to see questions you do not know on your test.

27. Lets try one
662

28. Time to practice
You examine a 2-hour-old foal. The foal has a heart rate of 100 bpm, and a continuous murmur loudest on the left side. Which of the following is the most likely explanation for these findings? 28

29. Time to practice A - Incipient septicemia
B - Ventricular septal defect
C - Normal in a neonatal foal
D - Hypoxic ischemic encephalopathy
E - Foal dysmaturity 29

30. Time to practice
The heart rate and a finding of a continuous murmur on the left side are NORMAL in newborn foals. Due to slight opening of the ductus arteriosis-usually closes in 4-5 days. Persistent patent ductus arteriosis is rare in horses. 30

31. “What if I don’t think this system will work for me
“What if I don’t think this system will work for me ?” Do what works for you. “How do I know when I should I change an answer ?”
Stick with your first answer unless you recognize that it is clearly not correct - studies show that changed answers are more frequently wrong.
“I am clueless about chickens/cardiology/box turtle halitosis, what do I do?”
Read, Predict, Eliminate, Select -The correct answer is guaranteed to be among the choices. Whittle the choices down to as few as possible and guess.

32. Can I review answers? Yes, but once you press “Save and Submit”
Your question block is out of your hands.

33. For a taste of the real thing Try 10 sample questions
Link: 33

34. Multiple choice tricks of the trade: Prognosis
Questions about prognosis tend to be all or nothing (ie: clearly GREAT or clearly HORRIBLE)
Prognosis/success rates by percentage:
Excellent % (ave: 95%) Good % (ave: 75%) Guarded/Fair % (ave: 50%)
Poor % (ave: 25%)
Grave % (ave: 5%)
Ref: Pasquini's, Tschauner's Guide to Sm. An Clinics, vol 1, 2nd ed. p. 11

35. Multiple choice tricks of the trade Images
CENTER Most photographers put lesion centrally in photos
Radiographs are an exception
Must look over WHOLE x-ray
History gives clues
Hit by car? Check for pelvic or femoral fracture, dislocation, Check for diaphragmatic hernia (bowel loop in chest)
Straining to urinate? Check bladder for stones
Regurgitation? Check for lung field for megaesophagus
No normals- Good images are hard to get UNLIKELY to see picture with nothing wrong

36. Where is the problem? Tongue ulcer, canine leishmaniasis
Image courtesy, Dr. Peter Schantz
Canine leishmaniasis
Tongue ulcer, canine leishmaniasis 36

37. Where is the problem? What is it? Ulcer, possible descemetocoele
Image courtesy, Dr. Kim Stanz
Ulcer, poss descmetocoele
What is it?
Ulcer, possible descemetocoele 37

38. If anything is wrong with this picture, in which quadrant is the problem?
History Hint: This beagle was hit by a car
Upper Left, ilial fracture
Image courtesy, Dr. Scot Nachbar
Upper left quadrant, Ilial fracture 38

39. Other Study Aids NBVME self assessments
Veterinary Board Games Flashcards
VIN Comprehensive NAVLE® Review

40. A good way to orient to NAVLE® topics NBVME self assessments
Produced by same people who write NAVLE®
$50, 200 questions, 30 days’ access
Four versions available (3 in French)
DON’T do all 200 questions in one sitting
DO questions per day look up answers to the ones you don’t know
Orients you to NAVLE-question style, depth
Link:

41. Good for a tune-up between cases Veterinary Board Game flashcard questions
Link:

42. Useful if you need structure to help stay on track VIN NAVLE® Review
Useful if you need structure to help stay on track VIN NAVLE® Review
Seven 2-hour live online NAVLE® webinars, (Sunday nights), plus an extensive library, notes
and a web forum on the Veterinary Information Network (VIN).
Useful if you need structure to help stay on track, or want a comprehensive review Week 1 NAVLE® Study strategy, Public health, Toxicology and more Week 2 Bovine Top 20 NAVLE® review Week 3 Pigs, Sheep, Goats, Poultry, Exotics Week 4 Equine Top 20 NAVLE® review Week 5 Feline Top 20 NAVLE® review Week 6 Canine Top 20 NAVLE® review Week 7 Test strategy, tips, mock exam
Cost to senior vet students in US/Canadian schools is $50, which may be later applied as credit to your first VIN CE course enrollment as a graduate veterinarian.
With species-specific support from board certified specialists: Lisle George, DVM, PhD, DACVIM (Bovine) Bob Doneley, BVSc, FACVSc (Avian Health, Small Ruminants) Emily Graves, VMD, MS, DACVIM (Equine) Michele Gaspar, DVM, DAVBP (Feline) Laura Ridge Cousins DVM, MS, DACVIM (Canine)
Steven I Mclaughlin, DVM, MPH, DACPVM (Public health, Epi, Reportables)
Link to Spring 2014 course page:

43. Study Smarter Start with a calendar 1st Pass: from now through ~Nov 1
Map out your study plan, week by week
Make test prep part of your routine
1st Pass: from now through ~Nov 1
All study-mode tests
Make or study summary notes
2nd Pass: last 4-5 weeks before NAVLE®
All test-mode tests
Review summary notes

44. The final 4-5 weeks Keep a routine
Get regular exercise …Run, swim, square-dance, walk your dog, hamster or wombat
Get up early every day, ….about same time you need to wake up on test day
Start with a decent breakfast
Go immediately into 2 hours of practice tests, then notes review
Get your mind & body into a routine so the big day feels routine too
Don't give up.
On test day, walk in with your head held high, and take it one question at a time

45. Thank you and good luck!
“No student knows his subject: the most he knows is where and how to find out the things he does not know.” –Woodrow Wilson

46. Selected references: Psychology of learning and decision-making
Good summaries “To Really Learn, Quit Studying and Take a Test”, New York Times, Jan 20, 2011, P. Belluck
Do You Suffer From Decision Fatigue?” New York Times, Aug 17, 2011, J. Tierney
Peer-reviewed Karpicke, J. D., & Blunt, J. R. (2011). Retrieval practice produces more learning than elaborative studying with concept mapping. Science, 331,
Roediger, H. L., & Karpicke, J. D. (2006). Test-enhanced learning: Taking memory tests improves long-term retention. Psychological Science, 17,
Roediger, H. L. & Karpicke, J. D. (2006). The power of testing memory: Basic research and implications for educational practice. Perspectives on Psychological Science, 1,
Carrier and Pashler: The Influence of Retrieval on Retention, Memory and Cognition, 1992, 20 (6)

47. General References
Building confidence before a challenge- An excellent TED talk. Well worth a watch
The summary of multiple choice strategies comes principally from: “What Smart Students Know” by Adam Robinson, co-founder of The Princeton Review George Wash. Univ. Academic Success Center- “Strategies for Multiple Choice Questions” Kaplan Test Prep US Medical Licensure Exam (USMLE) Strategy Sessions Convergence concept adapted from: “The Test Of Obscure Medical Information” Leo M. Harvill, Ph.D.
NAVLE Candidate Bulletin
Text Sample Questions Computerized sample questions, tutorial NBVME Self-assessments