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

2. “It is not enough to be a good chess player, you must also play well.” -Savielly Tartakower

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 the bark on a single tree
that she got lost, and a big bad wolf called NAVLE came and ate her The End

4. The need for speed It is time to go fast, people.
The goal is not to know everything
The goal is not to get every question right
The goal is to pass
In the forests of knowledge, let this be your map

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

6. 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

7. NAVLE Pass Rates Senior Students, AVMA Accredited Veterinary Schools Fall 2005-Spring 2009
Overall
Pass
Fall only*
Fall 05’-Spring 06’
95% (2549/2686)
Fall 06’
88% (2300/2616)
Fall 06’-Spring 07’
96% (2724/2841)
Fall 07’
90% (2486/2760)
Fall 07’-Spring 08’
97% (2816/2903)
Fall 08’
92% (2605/2828)
Fall 08’-Spring 09’
97% (2908/3009)
93% (2690/2880)
Increasing pass rates 2005 through person increase in test-takers from accredited schools, same period
*First time test-takers, senior students, AVMA accredited veterinary schools
Reference: NBVME NAVLE results page 7

8. NAVLE Pass Rates Senior Students & Graduates of Foreign Veterinary Schools Not Accredited by AVMA
Overall
Pass
Fall only
Fall 05’-Spring 06’
41% (534/1312)
Fall 06’
44% (308/698)
Fall 06’-Spring 07’
41% (628/1546)
Fall 07’
44% (352/799)
Fall 07’-Spring 08’
54% (370/680)
Fall 08’
51% (242/476)
Fall 08’-Spring 09’
64% (481/757)
68% (271/398)
Marked Increase in pass rates 2007 through 2009
Marked decrease in test-takers from non-accredited schools, same period
Changes likely due to 2007 requirement to pass BSCE test prior to NAVLE
Reference: NBVME NAVLE results page 8

9. NAVLE Pass Rates What do they mean to me?
“No matter what the pass rates are,
you don’t pass the NAVLE by accident.
Everyone has to prepare.”
-Dr. Zuku
(Steven I Mclaughlin DVM, MPH, DACVPM)

10. 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:

11. NAVLE Structure 72 (24%) Canine: 72 (24%) Feline: 51 (17%) Bovine:
84% of the NAVLE
72 (24%) Canine:
72 (24%) Feline:
51 (17%) Bovine:
51 (17%) Equine:
12 (4%) Porcine:
9 (3%) Pet Birds:
9 (3%) Public Health and Food Security:
9 (3%) Ovine/Caprine/Cervidae:
6 (2%) Other Small Animals:
6 (2%) Poultry:
3 (1%) Non-Species Specific:
300
Reference: 11

12. “Go where the money is” Remember Sutton’s Law
Most NAVLE points lie in the “Big 4” species 12

13. If the NAVLE is so broad, where do I start?
Be guided by NAVLE sample questions
and NBVME self assessments
A springboard to study
A pointer to key topics
Gives you a sense of the depth, style of questions
“C”
References: Text Sample Questions Computerized sample questions, tutorial NBVME Self-assessments

14. One of the best ways to prepare for NAVLE NBVME self assessments
Produced by same people who write NAVLE
$50, 200 questions, 30 days’ access
Two versions available, both worth doing
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: Natl. Board of Veterinary Medical Examiners (NBVME) Self-assessments

15. Study SmarterTM “Successful learning is not measured by how
many hours you study.
Successful learning means using the hours
you do have effectively.” Dr. Zuku
(Steven I Mclaughlin DVM, MPH, DACVPM)

16. A study technique that doesn’t work
“I spent 6 hours reading endocrinology
on Saturday,…..
But Monday, I didn’t remember any of it !”
“Reading = Learning” 16

17. USE IT OR LOSE IT MOST adults forget 50% of what they just read
And 80% within 24 hours BUT !!
Anything you have studied well will come back very quickly with a review
….if you make good notes

18. Another study technique that doesn’t work
Treating every single factoid as if it were important Ref: Dyce, Sack and Wensing Textbook of Veterinary Anatomy
No “take home message” here! Learn to recognize the most important 3 points 18

19. Study SmarterTM Start with a calendar
Map out your study plan, week by week
Make test prep part of your routine
First Pass: finish 4 weeks before test
All study-mode tests
Write out summary notes
Second Pass: during the 4 weeks before test
All test-mode tests
Review summary notes

20. Study strategies for NAVLE The 50:50 rule
Study ~50% -Map out the topic -Hit the books -Write summary notes -REVIEW those NOTES
Practice testing ~50% -ROUTINE a couple times a week
Goal: Finish study-mode tests, complete summary notes 4 weeks before the test

21. NAVLE Study Plan First Pass
Monday: Tests: 1. Dog #1, Cat # 1, Cow # 1, Horse #1, Cross-species #1, ~ 1 hour
2. Do NBVME self assessment Qs, note the ones you don't know Study: 1. Look up answers to NBVME self assessment Qs you don't know no more than 20 min per question Quick read of 5 key disease topics ~ 1 hour
Tuesday: Tests: 1. Do My Missed Qs from yesterday's tests Start new tests-Dog #2, Cat # 2, Cow # 2, Horse #2, Cross-sp # 2
3. Do NBVME self assessment Qs, note the ones you don't know Study: 1. Look up answers to NBVME self assessment Qs you don't know
2. Write 1/2 - page summary notes on the 5 topics ~ 2 hours ………………etc 21

22. Summary notes: 50% of your time
Why write summary notes?
Translates info into language your brain understands
Customized notes worth weight in gold in weeks before test
Map out the topic
DON’T reinvent the wheel
Use textbook table of contents or class syllabus
The rule of 5- never more then 5 ideas per topic
Add “Mental Velcro”
Images
Disease examples
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.

23. Mental velcro: Images
A picture IS worth a thousand words: Add pictures to your notes
Fluid-filled lungs: Pulmonary edema
“Floating lungs”: Pleural effusion
Images courtesy of Dr. Terri Defrancesco, DVM, ACVIM, All rights reserved, copyright

24. Mental velcro: Disease
Horner’s Syndrome: Remember "My 3rd Sunken Toe“ (Miosis, 3rd lid protrudes, Sunken eye, Ptosis) and "sweaty horses". A syndrome, not a disease per se.
See 4 things with Horner's, ALL associated with the eye: 1. MIOSIS (constricted pupil-lose sympathetic innervation) 2. PROTRUSION 3rd eyelid (nictitans) 3. ENOPTHALMOS (sunken eye) 4. PTOSIS (drooped eyelid), +/- anisocoria
Horner’s Syndrome: Remember "My 3rd Sunken Toe" (Miosis, 3rd lid protrudes, Sunken eye, Ptosis) and "sweaty horses". A syndrome, not a disease per se. Can see 4 things with Horner's, ALL associated with the eye: 1. MIOSIS (constricted pupil-lose sympathetic innervation) 2. PROTRUSION 3rd eyelid (nictitans) 3. ENOPTHALMOS (sunken eye) 4. PTOSIS (drooped eyelid), +/- anisocoria
What is it?
Image courtesy, Dr. Joel Mills, Wikimedia Commons 24

25. Map Out Your Topic: An easier clinical example-Cryptoccocosis
You are on the ground in the forest of “Small Animal Medicine”, looking at a tree called “Fungal infections” and a leaf called “Cryptococcus”.
To figure out where you are
(and to get where you want to go),
Visualize where you are from 1000 feet up

26. Map example: Important Fungal Diseases
Map from 1000 feet
3 “C’s”
A. Candidiasis
B. Cocciomycosis
C. Cryptococcosis
3 “BAH, humbugs”
A. Blastomycosis
B. Aspergillosis
C. Histoplasmosis
Map from 100 feet
3 “C’s”
A. Candidiasis
B. Cocciomycosis
C. Cryptococcosis
Map on the ground Cryptococcosis
a. Presentation
b. DDX
c. Test of Choice
d. Treatment
e. Prevention/Prognosis
You are here

27. An example of good summary notes: Cryptococcosis
References: Cote’, Veterinary Clinical Advisor, Dogs and Cats, 1st ed, pp & Pasquini& Pasquini, Tschauner’s Guide to Small Animal Clinics, 2nd ed. p. 703 Notes developed by senior veterinary student for educational use in preparation for NAVLE Image source unreferenced. May be used only for educational purposes 27

28. Map Out Your Topic: A harder example-Pharmacology
You are on the ground in the forest of “Pharmacology”, looking at a tree called “Misc antibiotics” and a leaf called “Rifampin”.
To figure out where you are
(and to get where you want to go),
Visualize where you are from 10,000 feet up

29. Map example: Pharmacology
Map from 10,000 feet
5 “Antis”
Antibacterials
Antifungals
Antiparasitics
Antivirals
Antineoplastics
5 “keys”
Key Cardio drugs
Key Optho drugs
Key Repro drugs
Key Endo drugs
Key Renal drugs
Misc
Key antidotes/tox reversal agents
Analgesics
Tranquilizers
Map from 1000 feet
I. Antibacterials A. ‘cidals B. ‘statics
C. Misc antibiotics
Map from 100 feet C. Misc antibiotics Chloramphenicol
2. Rifampin Metronidazole
Map on the ground Rifampin
a. Gen info
b. Primary use
c. Contraindications
d. Cautions
e. “mental velcro” (Image, disease)
You are here

30. Summary notes part 1: Pharmacology, Rifampin
2. Rifampin a.General-‘cidal or ‘static dep. on microbe
b.Primary use -Rx Rhodococcus equi, young horses
c.Contraindication -Beware in hypersens animals, hepatic dysfxn
d.Caution ). May cz red-orange urine, tears, sweat ). Don’t use alone or see rapid resistance
3). Give on empty stomach
e.Mental velcro- Rhodococcus equi
References: Plumb’s Vet Drug Formulary 5th ed. pp.992-4, Merck Vet Manual online,

31. Summary notes part 2: Rifampin Mental velcro (image and a disease)
References: Pasquini, Pasquini & Woods, Guide to Equine Clinics, 3rd ed. p. 113 Notes developed by senior veterinary student for educational use preparation for NAVLE Image courtesy, Angeline Warner, DVM, D. Sc: 31

32. Where to get a fast disease summary
From: Pasquini, Pasquini & Woods, Guide to Equine Clinics, 3rd ed. p. 113 32

33. Where to start with summary notes
Summarize most important diseases first ie:
Heartworm more important than aortic coarctation (whatever that is)
Diabetes mellitus more important than pheochromocytoma
Equine laminitis more important than rare rachitic ringbone
Not sure where to start?
See suggested “Top 20s” on the Zuku Review website
Feeling ambitious? The 2003 NAVLE Job Analysis survey lists about a 1000 conditions you can bone up on…….

34. Outside a dog, a book is a man’s best friend
Outside a dog, a book is a man’s best friend. Inside a dog, it’s too dark to read Groucho Marx
If you believe everything you read, better not read Japanese proverb 34

35. 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: *Veterinary Clinical Advisor, Dogs and Cats, 1st ed. Cote' ed. *Tschauner's Guide to Small Animal Clinics 2nd ed.—Pasquini Blackwell's 5 Minute Vet Consult, Canine-Feline 4th ed. Tilley & Smith eds.
Pharmacology: *Plumb’s Veterinary Drug Handbook, 5th edition, Donald C. Plumb
The original and a favorite, available as a book or online through VIN
Clinical Pathology: Duncan and Prasse's Clinical Pathology, 4th ed.
35 excellent case studies in appendix. We like this one, but other texts are also good.
*Zuku Review Pick of the LitterTM

36. Practice testing for NAVLE: 50% 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.

37. 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.

38. 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.

39. “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.

40. The 24-hour “golden period” of short-term memory
A mistake is the best teacher
Mistakes sting
Sting helps you remember,
…...IF you redo missed question within 24 hrs
After 24 hours, most new info fades from memory
Starting from 0
Note questions you miss today on scratch paper
Redo “Missed Questions” tomorrow
Reinforces weak areas fast

41. Sources of practice questions
Free
NAVLE sample tests
Text version Computerized version
CAPC parasitology test
Vet Board Games question of the day
Zuku Review Question of the day Archive
Subscription-based
NBVME Self Assessments
VIN NAVLE prep course
Vetprep online NAVLE course
Zuku Review online NAVLE course
Other NAVLE prep aids
Vet Board Games cards & iPhone application
Saunders Comprehensive Review for the NAVLE®, Patricia Schenck DVM, PhD (Paperback with CD-due out late Sept no information available yet on contents)

42. Pop Quiz What is a Cook's speculum? A) Three-pronged ear speculum
B)   Four-pronged rectal speculum
C)   Three-pronged nasal speculum       
D)   Three-pronged rectal speculum

43. Multiple choice tricks of the trade: Convergence
What is a Cook's speculum?
A)   Three-pronged ear speculum           
B)   Four-pronged rectal speculum
C)   Three-pronged nasal speculum       
D)   Three-pronged rectal speculum
This is an example of convergence.  Options A, C and D all contain the words "three-pronged“ Options B and D both contain the word "rectal." These two sets converge at option D
Adapted from: Leo M. Harvill, Ph.D. “The Test Of Obscure Medical Information”

44. 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

45. 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

46. If there is a problem in this picture, where is it ? (click link)
Intussusception, Hamster, center of image Click this version for explanatory text:
Reference: The Merck Veterinary Manual online edition

47. Where is the problem? Tongue ulcer, canine leishmaniasis
Image courtesy, Dr. Peter Schantz
Canine leishmaniasis
Tongue ulcer, canine leishmaniasis 47

48. Where is the problem? What is it? Ulcer, possible descemetocoele
Image courtesy, Dr. Kim Stanz
Ulcer, poss descmetocoele
What is it?
Ulcer, possible descemetocoele 48

49. Where is the problem? What is it? Endocardiosis, mitral valve
Image courtesy, Dr. Terri Defrancesco
Mitral endocardiosis
What is it?
Endocardiosis, mitral valve 49

50. What, if anything, is wrong with this picture?
History Hint: This cat is having urinary accidents
Bladder stones
Image courtesy, Dr. Scot Nachbar
Bladder stones 50

51. 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 51

52. What, if anything, is wrong with this picture?
History Hint: This 6 month old Labrador regurgitates soon after eating
Megaesophagus: note ventral deviation of the tracheal carina, and dilation of the esophagus above
Megaesophagus: note ventral deviation of tracheal carina, dilation of esophagus
Image courtesy, Dr. Terri Defrancesco 52

53. Online Case Study & Image Resources
Surgery case studies Radiology case studies Radiology artifacts Clin Path Case studies Clin Path images
Pathology/Histopathology images Vet video library: Merck images online
Tech hint:
Right-click your mouse over an internet image, to copy and paste it elsewhere

54. The final 4 weeks Second Pass
“In the final weeks before a big race, you change your training to mimic the race. In the final weeks before test day, change your study to mimic the real test” 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.

55. The final 4 weeks Second Pass
Study
-REVIEW your notes -Skim misc topics not in notes -Test yourself with flashcards, friends, game cards
Practice testing Do timed test-mode tests -60-question tests build stamina -Random topics -No answers as you go -Mimics the real thing
Goal: Finish all test-mode tests Redo “Missed questions” within 24 hours Review summary notes until solid in your mind

56. The final 4 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

57. Remember 4 things ~50% study, ~50% practice testing
Redo “missed questions” w/in 24 hours
Try to finish first pass on summary notes & study-mode tests 4 weeks before test
In final 4 weeks do test-mode tests, review notes

58. If Time is Short ~1/3 time reviewing notes ~2/3 time taking tests
Read, Predict, Select, or Eliminate
Redo "My Missed Questions“ w/in 24 hours
Pay attention to images in questions
Finish all test-mode tests in final week
Stay Positive
Panic is not productive; don’t waste energy on it
Test-takers with forward momentum and a positive attitude do better on tests
Do what you can, keep moving, and don't give up

59. 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

60. References
The summary of multiple choice strategies comes principally from:
“What Smart Students Know” by Adam Robinson, co-founder of The Princeton Review test preparation company George Washington University 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