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]

Overview

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:

Develop test-taking strategies by managing time correctly
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

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.

Matching Pair Questions

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)

Internal Resources and References

Use the Wikidoc.org content
Promote Wikidoc use inserting internal links into the explanations

External Resources and References

Mention external sources used only if necessary 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
Kaplan Review Series
Falcon Review Series

Websites

www.usmle-forums.com recent test takers give feedback about their experience and commonly tested facts. Updated hourly.

Qbanks

USMLERx, Uworld, Kaplan

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