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Effective Study Strategies for the North American Veterinary Licensing Exam (NAVLE ®)
Steven I McLaughlin DVM, MPH, DACVPM
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“To achieve great things, two things are needed; a plan, and not quite enough time.” Leonard Bernstein
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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
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Today’s talk: North American Veterinary Licensing Exam (NAVLE®)
NAVLE structure, pass rates Study strategies for NAVLE Test-taking strategies for NAVLE
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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
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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:
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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
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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
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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?
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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
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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.
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A picture IS worth a thousand words:
Fluid-filled lungs: Pulmonary edema “Floating lungs”: Pleural effusion Images courtesy of Dr. Terri Defrancesco, DVM, ACVIM,
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Traditional notes: What most notes look like
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PRESENTATION AND CLASSIC CASES
What You Want: Visual Summary Notes PRESENTATION AND CLASSIC CASES 14
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Visual Summary Notes TESTS OF CHOICE 15
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DIFFERENTIAL DIAGNOSIS
Visual Summary Notes DIFFERENTIAL DIAGNOSIS 16
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Visual Summary Notes TREATMENT 17
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Special Notes Topics: Acid Base Review
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Special Notes Topics: Equine Lameness
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Coming Soon: Zuku Dynamic FlashNotes™ Like flashcards, with notes!
How would you treat a standing cow with a presumptive diagnosis of listeriosis? 20
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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
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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
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What if I am not a horse person? (or cow person)
From: Pasquini, Pasquini & Woods, Guide to Equine Clinics, 3rd ed. p. 113 23
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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.
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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.
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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.
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Lets try one 662
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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
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Time to practice A - Incipient septicemia
B - Ventricular septal defect C - Normal in a neonatal foal D - Hypoxic ischemic encephalopathy E - Foal dysmaturity 29
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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
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“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.
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Can I review answers? Yes, but once you press “Save and Submit”
Your question block is out of your hands.
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For a taste of the real thing Try 10 sample questions
Link: 33
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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
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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
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Where is the problem? Tongue ulcer, canine leishmaniasis
Image courtesy, Dr. Peter Schantz Canine leishmaniasis Tongue ulcer, canine leishmaniasis 36
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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
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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
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Other Study Aids NBVME self assessments
Veterinary Board Games Flashcards VIN Comprehensive NAVLE® Review
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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:
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Good for a tune-up between cases Veterinary Board Game flashcard questions
Link:
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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:
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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
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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
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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
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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)
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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
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