Wiki Doc Board Review Guidelines

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gonzalo Romero, M.D.[2]

Steps to Build a Question Stem

1. Read and understand the tested material to grasp the basic principles, diagnosis, management and therapeutics according to the BOARD level.

2. 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.

3. Pick a specific content

4. Use the WBR Checklist

5. Use Wiki Doc to obtain information,links, pictures, videos, and promote their use on the explanations.

Goal of Building a Good Question Stem

The goal of building these questions is to recreate a Board Scenario that serves both to:

1. Develop test-taking strategies by managing time correctly
2. Test high yield knowledge in a typical Board presentation

Do Not Give Away the Answer

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 like which one is incorrect, not correct, false.

Stems Length

• Long stems: are extremely helpful! They create 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

1. Symptoms or clinical presentation
2. Physical exam findings
3. Laboratory findings
4. Diagnosis
5. Treatment of Choice
6. Mechanism of action of treatment of choice
7. 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.

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 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)

Other Wiki Links

• http://www.wikidoc.org/index.php/MCAT
• http://www.wikidoc.org/index.php/USMLE_Step_1
• http://www.wikidoc.org/index.php/USMLE_Step_2-CK
• http://www.wikidoc.org/index.php/USMLE_Step_2_Clinical_Skills
• http://www.wikidoc.org/index.php/USMLE_Step_3
• http://www.wikidoc.org/index.php/COMLEX-USA
• http://www.wikidoc.org/index.php/COMLEX-USA_Step_1
• http://www.wikidoc.org/index.php/COMLEX-USA_Step_2CE
• http://www.wikidoc.org/index.php/COMLEX-USA_Step_3

Other External Links

• http://www.usmle.org/pdfs/step-1/2013content_step1.pdf
• http://www.usmle.org/pdfs/step-2-ck/2012--13_FINAL_S2_GSI.pdf
• http://www.usmle.org/pdfs/step-3/2013content_step3.pdf
• http://www.nbme.org/
• http://www.nbome.org/
• http://www.ecfmg.org/
• http://www.osteopathic.org/Pages/default.aspx