Wiki Doc Board Review Guidelines
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Gonzalo A. Romero, M.D. [2]
Overview
The Wiki Doc Board Review aims to help test takers towards their exam preparation. On this section the user can access several Board Review Questions at different levels. They include USMLE STEP 1, USMLE STEP 2 Clinical Knowledge (CK), USMLE STEP 3, MCAT and BOARD Certification.
These Wikidoc Board Review Guidelines (WBR Guidelines) are geared towards the editors who want to create and add questions contributing to the WBR Questions Pool.
Adding questions in 12 STEPS, it's that easy!
Steps to add a question:
- Go to http://www.wikidoc.org/ and click on Board Review on the Upper Right of the Encyclopedia http://www.wikidoc.org/index.php/Board_Review
- Click on the Click Here to Add Questions button. It will redirect you to http://wikidoc.org/index.php/Special:FormEdit/WBRQuestion/WBR
- Type in your name in the Author Box
- Select the Exam Type
- Type the Stem into the Question Box
- Introduce an Overall Explanation into the Box focusing on the correct answer choice
- Type the Answer A choice
- Type the corresponding explanation for Answer A
- Repeat the last 2 steps for Answer choices B, C, D and E
- Select the correct answer choice
- Select Reviewed if all the bowes on the WBR Quality Checklist are marked
- Add an image if you would like
CONGRATULATIONS! You just created a Question!
Adding tables
Editing existing questions
Other editing help
For any other editing questions, do not hesitate to contact Wiki Doc.
Wiki Doc quality check
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Wiki Doc Board review checklist
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Steps to build a question stem
The goal of building these questions is to recreate a Board Scenario that serves both to:
- Develop test-taking strategies by managing time correctly
- Test high yield knowledge in a typical Board presentation
The Steps to build a question stem are the following:
- Read and understand the tested material to grasp the basic principles, diagnosis, management and therapeutics according to the BOARD level.
- Be familiar with the format, content and high Yield material frequently asked. Try to take many exams through the NBME website [[[3]]], the actual exam and other Qbanks. Respect Copy Rights sources.
- Pick a specific content
- Use the WBR Checklist
- Use Wiki Doc to obtain information,links, pictures, videos, and promote their use on the explanations.
Do not give away the answer
Challenge the test taker! Avoid using proper or specific signs. Describe signs and symptoms in simple terms to give the hints without giving away the answer. Example: “marfanoid” use instead: long extremities, skinny, tall. Do not ask negatively. Example "which of the following is incorrect, not correct or false".
Stem length
- Long stems: Are extremely helpful! They create a challenge for the test taker who has to read quickly, yet carefully to pick up the important info.
- Short and moderate stems: Test specific facts. It is useful to add pictures/videos/sounds/tables/graph.
Multi-step questions
Test the process, not the content including 2 ot 3 Step questions.
Process
- Symptoms or clinical presentation
- Physical exam findings
- Laboratory findings
- Diagnosis
- Treatment of Choice
- Mechanism of action of treatment of choice
- Most common adverse effect
Example
Micro questions require the reader to make a diagnosis, know the correct drug and then the mechanism of action of the drug (3 steps). An equally difficult but less elegant question would ask what HLA-subtype is associated with some rare rheumatological disease.
Sequential item questions
The format remains the same as above, but it tests two or three different concepts on separate questions having the same clinical vignette.
Matching sets
The question begins with answer options followed by multiple questions. The answers to these questions are in the options at the beginning.
Answer explanations
Overall explanation
Connect all the puzzle pieces. Explain the pertinent positive findings (symptoms, signs) as a clinician, not just list the topic. (i.e. the patient has … which is a typical presentation of…). Also explain the negative pertinent. Justify why that choice is correct. Only ONE answer is the best or the most appropriate one.
Answer choice explanation
- Include concise, yet thorough explanation providing a high yield chunk of info.
- Concisely explain the right answer.
- Add info missing on the overall explanation to the right answer choice and explain the wrong choices and why they are not correct.
- Explain the wrong choices
Educational objective
- Include short high yield fact at the end of the explanation (1 or 2 take-home sentences/phrases)
References
Internal resources
- Use the Wikidoc.org content
- Promote Wikidoc use inserting internal links into the explanations
External resources
Mention external sources used if you their content is used to respect Copy Rights.
Books
- First Aid latest edition for STEP 1
- For Step 1: updated yearly by students who aced the exam
- For Step 2CK: updated biyearly
- Master The Boards for Step 2CK and Step3
- Med-Essentials For Step1
- Other Review Series
Websites
-Recent test takers give feedback about their experience and commonly tested facts. Updated hourly.
USMLE STEP 1 question design
Vary the method Test the basic principles using graphs, diagrams, pictures, calculations, clinical scenarios/cases, and multimedia Reuse vignettes and ask in a different way Use both long and short vignettes
USMLE STEP 2CK (Clinical Knowledge) question design
- Follow the most recent Algorithms/Guidelines from the Wiki.
- Useful Resources MTB and FA
- Include basic STEP 1 questions; 50-60% of the knowledge from STEP 2CK comes from STEP 1
- Include Labs
- Long stems
- Accommodate information within the vignette that will benefit the test taker to identify the proper answer choice
- Include extra information that is not necessary leading towards the correct answer
- Audio and video questions would be ideal also
Case scenarios
- Age of patient
- Sex
- Chief complaint
- Vitals
- Describe the chief complaint
- Physical examination findings
- Significant past history if any
- Laboratory findings
- Image or video (if applicable)
Commonly asked questions
- What is the most likely diagnosis?
- What is the most likely cause for this condition?
- What is the next best step in management?
- What is the best initial treatment?
- What is the best treatment for this condition?
- What is the best/ most accurate laboratory test to confirm diagnosis?
- What is the drug of choice to treat this condition?
- What is the most likely physical exam finding? (eg. On auscultation, abdominal examination, etc.)
- Which of the following is the most likely underlying mechanism?
- What is the most common risk factor for this condition?
- What is the most common complication of this condition?
- What is the best drug/ drug of choice used to treat this condition?
USMLE STEP 3 question design
Testing mainly on management of case, covering the following fields:
Application of concepts
- What is the most likely cause for this condition?
- What is the most likely underlying mechanism?
- What is the cause of (sign/ physical exam finding)?
- Questions related to research studies
History and physical examination
- What is the most likely physical exam finding?
- What facts from the past history are important for diagnosis?
- What is the most common risk factor for this condition?
Laboratory and diagnostic Studies
- What is the most appropriate/accurate laboratory test to evaluate this patient?
- What is the most appropriate laboratory test to evaluate the efficacy of current treatment?
- What is the best initial laboratory test to order?
- What is the most likely result of this laboratory test seen in this condition?
- What is the most likely laboratory finding seen in this condition?
Diagnosis
- What is the most likely diagnosis?
- Which condition is most commonly associated with ____?
Prognosis
- Which of the following factors influences prognosis (good or bad)?
- Which of the following is the best/ worst prognostic indicator?
- Which of the following laboratory finding indicates best/ worst prognosis?
- After follow-up, which of the following is the most common factor that indicates favorable prognosis?
- What is the most appropriate counseling advice?
- What is the most common complication of this condition?
- What is the most likely outcome of this condition?
Management
- What is the next best step in management of this patient?
- What is the most appropriate screening test?
- What is the most appropriate preventive measure for this condition?
- What is the best initial treatment?
- What is the most accurate treatment?What is the best drug/ drug of choice used to treat this condition?
- What is the most appropriate discharge plan?
- Which drug is contraindicated in the treatment of this condition?
- Which of the following is a contraindication for the use of this drug?
- What is the most likely adverse effect of this drug?
Ethics and principles
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