{"id":1889,"date":"2018-08-01T07:00:00","date_gmt":"2018-08-01T11:00:00","guid":{"rendered":"https:\/\/www.roshreview.com\/?p=1889"},"modified":"2022-04-26T23:08:33","modified_gmt":"2022-04-26T23:08:33","slug":"increase-your-pediatrics-certification-exam-by-50-points","status":"publish","type":"post","link":"https:\/\/www.roshreview.com\/blog\/increase-your-pediatrics-certification-exam-by-50-points\/","title":{"rendered":"How to Increase Your Pediatric Board Exam Score"},"content":{"rendered":"\n<h6 class=\"wp-block-heading\">This article covers two easy strategies to help increase your Pediatric Board Exam score. While there is no magic pill or wand that will increase your score, these two techniques are useful, easy to implement, and only require a little of your time.<\/h6>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p>The first strategy is to <strong>identify what you don\u2019t know<\/strong>. Sounds easy, right? The key is to go through a curriculum and identify what you don\u2019t know\u2014not what you are <em>weak<\/em> at\u2014but what you don\u2019t know. The second strategy is to <strong>take advantage of human error<\/strong>. Humans write tests, and humans make errors. By paying attention to five types of flaws that question writers make, you can narrow down an answer choice to either the correct answer or a 50\/50 probability\u2014even without knowing anything about the topic. By combining these two strategies, you\u2019ll be able to increase your Pediatric Board Exam, which would be the difference between passing or failing. Let\u2019s get started.<\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h6 class=\"wp-block-heading\">Strategy 1: Determining your unknown unknowns<\/h6>\n\n\n\n<p>As you begin to study for your exam there are areas you are comfortable with. Maybe you have a special interest in nephrology and feel confident with any question that might be asked on <a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-Fanconi-Syndrome-global-proximal-tubular-dysfunction-copy.png\" target=\"_blank\">Fanconi syndrome<\/a>. Because you are confident in nephrology, you spend less time reviewing it. This is one of your <em><strong>known knowns<\/strong><\/em>. There is little utility in spending too much time on your known knowns when preparing for your exam.<\/p>\n\n\n\n<p>Suppose you feel that your understanding of liver disease is poor. <a href=\"https:\/\/2yr1gw411ycx1bv1dm2k152g-wpengine.netdna-ssl.com\/wp-content\/uploads\/Image-Hepatic-Encephalopathy.png\" target=\"_blank\" rel=\"noreferrer noopener\">Hepatic encephalopathy<\/a> is still just a term to you. You don\u2019t feel confident that you understand how or why it occurs, or how to manage the condition. Liver disease is a <strong><em>known unknown<\/em><\/strong>. But because you recognize this specific deficiency, you can target your learning to diseases of the liver.<\/p>\n\n\n\n<p>Once you start to focus your learning, you\u2019ll come across many concepts and ideas that you may know nothing about. These are your <strong><em>unknown unknowns<\/em><\/strong>, a concept created by psychologists Joseph Luft and Harrington Ingham. It is part of their \u201cJohari window,\u201d a tool that helps users identify blind spots about themselves and others.<\/p>\n\n\n\n<p><strong><em>Known unknowns<\/em><\/strong> are things you\u2019re aware that you don\u2019t know\u2014you can recognize that you don\u2019t understand them. <strong><em>Unknown unknowns<\/em><\/strong>, however, are unexpected because you don\u2019t know they exist.<\/p>\n\n\n\n<p>The way to supercharge your board exam score is to identify your <strong><em>unknown<\/em><\/strong><em> <\/em><strong><em>unknowns<\/em><\/strong>. It takes a little effort, but the steps are rather easy. All you need are two things:<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"363\" height=\"101\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Notebook-and-Time-1.png\" alt=\"Notebook and time\" class=\"wp-image-6196\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Notebook-and-Time-1.png 363w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Notebook-and-Time-1-300x83.png 300w\" sizes=\"auto, (max-width: 363px) 100vw, 363px\" \/><\/figure><\/div>\n\n\n\n<p>The system works like this.<\/p>\n\n\n\n<p><strong>Step 1:<\/strong> Answer a <strong>question from a question bank<\/strong>. If you get the answer wrong, read the explanation. Then write down in your notebook the part of the explanation that describes why the correct answer is correct. This process helps to identify your <em><strong>unknown unknowns<\/strong><\/em>. Subsequently, if there is any other information that you did not know or somewhat knew, record it as well in your notebook under the same topic.<\/p>\n\n\n\n<p><strong>You should do this for every question you get incorrect.<\/strong> I also encourage it for questions you may have answered correctly but discovered new information in the explanation that you previously did not know.&nbsp;<\/p>\n\n\n\n<p><strong>Step 2:<\/strong> Start each study session by <strong>reviewing your notebook<\/strong> that contains your unknown unknowns. As you do more questions, you will get questions wrong on topics already recorded in your notebook. For example, if you answer a question incorrectly on which age group most commonly presents with juvenile ankylosing spondylitis, you\u2019ll record in your notebook something like &#8220;Juvenile ankylosing spondylitis: Epidemiology includes boys around 12 years old.&#8221; Two weeks later when you can\u2019t name the physical exam maneuver&nbsp;characterized by limited lumbosacral flexion with forward bending, you should go back through your notebook to find your first entry on juvenile ankylosing spondylitis and add the Schober test as part of the evaluation.<\/p>\n\n\n\n<p>After a month or two of recording your incorrect answer explanations, you will have a filled notebook of your <em><strong>unknown unknowns<\/strong><\/em> and maybe many of your <em><strong>known unknowns<\/strong><\/em>. If you do this on a consistent basis and get through 1,000 to 2,000 question bank questions for a 300-question standardized exam, you&#8217;ll have identified most of your blind spots that questions can be asked about. <strong>You will convert your <em>unknown unknowns<\/em> to <em>known knowns<\/em>.&nbsp;<\/strong><\/p>\n\n\n\n<p>You can use the same system and process to prepare for all standardized exams.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"629\" height=\"443\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Study-schedule-1.png\" alt=\"Study schedule\" class=\"wp-image-6197\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Study-schedule-1.png 629w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Study-schedule-1-300x211.png 300w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Study-schedule-1-600x423.png 600w\" sizes=\"auto, (max-width: 629px) 100vw, 629px\" \/><\/figure><\/div>\n\n\n\n<p>With the Pediatric Board Exam waiting for you, now is the perfect time to begin this system. It leaves time to accumulate your <strong><em>unknown unknowns<\/em><\/strong>.<\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<h6 class=\"wp-block-heading\">Strategy 2: Taking advantage of human error<\/h6>\n\n\n\n<p>Earlier in this post, I mentioned that you&#8217;ll need two things to<span>&nbsp;supercharge your standardized exam score: a notebook and time. The notebook you can buy anytime. However, time disappears. <\/span><\/p>\n\n\n\n<p>Taking the time to identify your unknown unknowns will prepare you for the exam. But, we know <strong>five ways<\/strong> you can improve your score simply by showing up to your exam.<\/p>\n\n\n\n<p><strong>You can use the errors made by question writers to boost your score<\/strong>.&nbsp;<\/p>\n\n\n\n<h6 class=\"wp-block-heading\">The Anatomy of a Question<\/h6>\n\n\n\n<p>First, let&#8217;s understand the anatomy of a question.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/anatomy-of-a-question@2x-1.png\" alt=\"Question, stem, lead in\" class=\"wp-image-6776\" width=\"246\" height=\"178\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/anatomy-of-a-question@2x-1.png 492w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/anatomy-of-a-question@2x-1-300x217.png 300w\" sizes=\"auto, (max-width: 246px) 100vw, 246px\" \/><\/figure><\/div>\n\n\n<p><span style=\"color: #1991eb\">A <span style=\"font-weight: 400\">3-year-old boy, former 28-week preemie, presents with a large, firm, nontender abdominal mass. Findings on physical examination reveal pallor, hemihypertrophy, and a protruding tongue. A smooth, round abdominal mass approximately 6 cm in diameter is palpated on the right upper quadrant of his abdomen. The remainder of the physical examination findings are normal. Initial laboratory values show a white blood cell count of 10,500&nbsp;with 10% polymorphonuclear leukocytes, 8% lymphocytes, 4% monocytes, and 1% eosinophils. Hemoglobin is 8, mean corpuscular volume 72, and platelets 600. Aspartate aminotransferase is 140 U\/L, alanine aminotransferase is 125 U\/L, total bilirubin is 6 mg\/dL, and alpha-fetoprotein is 150,000 mcg\/mL.<\/span><\/span> <span style=\"color: #48952c\"><span style=\"font-weight: 400\">What is the most likely diagnosis?<\/span><\/span><\/p>\n\n\n<p>A question is made up of the stem and the lead-in. The stem contains the details of the question such as the clinical presentation, past medical history, and laboratory results. But, the critical part of the question is the lead-in. The question writer uses the lead-in to find out what you know or don&#8217;t know about the topic in the stem, and it is also where question writers make errors. By applying basic grammatical analysis, you will be able to identify the correct answer or at least narrow down the answer choices without knowing anything about the topic. Here are our first two tips:<\/p>\n\n\n\n<p>1. Pay attention to <strong>grammatical cues.<\/strong><\/p>\n\n\n<p><span style=\"color: #f6222a\"><strong data-rich-text-format-boundary=\"true\">Grammatical cues<\/strong>:<\/span><span>&nbsp;one or more answer choices&nbsp;<span style=\"color: #f6222a\">(distractors)<\/span>&nbsp;don\u2019t follow grammatically from the&nbsp;<span style=\"color: #48952c\">lead-in<\/span>.<br data-rich-text-line-break=\"true\"><br data-rich-text-line-break=\"true\"><span style=\"color: #1991eb\">A <span style=\"font-weight: 400\">3-year-old girl presents to the emergency department for evaluation of decreased appetite and is noted to have bruising in multiple stages of healing on her back and abdomen. She is hemodynamically stable.<\/span><\/span> <span style=\"color: #48952c\"><span style=\"font-weight: 400\">What would be the most appropriate initial imaging modality for evaluation of her injuries?<\/span><\/span><br data-rich-text-line-break=\"true\"><br data-rich-text-line-break=\"true\"><span style=\"color: #f6222a\"><span style=\"font-weight: 400;color: #000000\">A. CT of the abdomen and pelvis with IV contrast<\/span><br>B. <span style=\"font-weight: 400\">Detailed history from all caregivers<\/span><\/span><br data-rich-text-line-break=\"true\">C. <span style=\"font-weight: 400\">MRI of the abdomen and pelvis with IV contrast<\/span><br data-rich-text-line-break=\"true\"><span style=\"color: #f6222a\">D. <span style=\"font-weight: 400\">Report to child protective services<\/span><\/span><br data-rich-text-line-break=\"true\"><br data-rich-text-line-break=\"true\"><span style=\"color: #f6222a\"><span style=\"font-weight: 400\">B and D<\/span> do not follow grammatically from the lead-in. A good test taker can eliminate these.<\/span><\/span><\/p>\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p>2. Focus on <strong>logical cues<\/strong>.<\/p>\n\n\n<p><span style=\"color: #f6222a\"><strong>Logical cues<\/strong>:<\/span><span>&nbsp;one or more answer choices don\u2019t logically fit in with the other choices.<\/span><\/p>\n<p><span style=\"color: #1991eb\">You are suspicious that a 9-year-old boy has appendicitis.<\/span> <span style=\"color: #48952c\">Which of the following signs is most sensitive for the diagnosis of appendicitis?<\/span><\/p>\n<p><span style=\"color: #f6222a\">A. Nausea<\/span><br>B. Pain with extension of the hip joint<br>C. Rebound tenderness<br>D. Right lower quadrant tenderness<\/p>\n<p><span style=\"color: #f6222a\">Nausea is not a &#8220;sign&#8221; and can be eliminated by a good test taker.<\/span><\/p>\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p>Let&#8217;s now focus on answer choices to identify a few more areas where we can gain an edge.<\/p>\n\n\n\n<h6 class=\"wp-block-heading\">The Anatomy of Answer Choices<\/h6>\n\n\n<p><strong>Question: <\/strong><span style=\"color: #000000\">A <\/span><strong><span style=\"color: #000000\"><span style=\"font-weight: 400\">3-year-old boy, former 28-week preemie, presents with a large, firm, nontender abdominal mass. Findings on physical examination reveal pallor, hemihypertrophy, and a protruding tongue. A smooth, round abdominal mass approximately 6 cm in diameter is palpated on the right upper quadrant of his abdomen. The remainder of the physical examination findings are normal. Initial laboratory values show a white blood cell count of 10,500 with 10% polymorphonuclear leukocytes, 8% lymphocytes, 4% monocytes, and 1% eosinophils. Hemoglobin is 8, mean corpuscular volume 72, and platelets 600. Aspartate aminotransferase is 140 U\/L, alanine aminotransferase is 125 U\/L, total bilirubin is 6 mg\/dL, and alpha-fetoprotein is 150,000 mcg\/mL.&nbsp;<\/span><strong>What is the most likely diagnosis?<\/strong><\/span><\/strong><\/p>\n<p><span style=\"color: #000000\"><span style=\"color: #f6222a\">A. Constipation<br><span style=\"color: #48952c\">B. Hepatoblastoma<br><\/span><\/span><\/span><span style=\"color: #000000\"><span style=\"color: #f6222a\">C. Nephroblastoma<br>D. Neuroblastoma<\/span><\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-10389 \" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/peds-correct-answer@2x-2-300x106.png\" alt=\"Correct answer choice B, distractors C, D, A\" width=\"195\" height=\"69\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/peds-correct-answer@2x-2-300x106.png 300w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/peds-correct-answer@2x-2.png 420w\" sizes=\"auto, (max-width: 195px) 100vw, 195px\" \/><\/p>\n<p>The lead-in asks about the most likely diagnosis, so think carefully through each answer option. Here are the distractors:<\/p>\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/peds-answers@2x-551x1024.png\" alt=\"\" class=\"wp-image-10388\" width=\"413\" height=\"768\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/peds-answers@2x-551x1024.png 551w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/peds-answers@2x-161x300.png 161w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/peds-answers@2x-600x1115.png 600w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/peds-answers@2x.png 744w\" sizes=\"auto, (max-width: 413px) 100vw, 413px\" \/><\/figure><\/div>\n\n\n\n<p>Once you understand the goal of the question writer to create answer choices that are supposed to discriminate knowledge, it is easier to exploit technical flaws and improve the odds of getting a question correct. The following three pointers round out our five tips that can help you answer a question correctly:<\/p>\n\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p>3. Look for answer choices containing <strong>absolute terms<\/strong>.<\/p>\n\n\n<p><span style=\"color: #f6222a\"><strong>Absolute terms<\/strong><\/span>:<span>&nbsp;terms such as&nbsp;<\/span><span style=\"color: #f6222a\">\u201calways\u201d<\/span><span>&nbsp;or&nbsp;<\/span><span style=\"color: #f6222a\">\u201cnever.\u201d<\/span><span> When used in the answer options, these terms usually indicate an incorrect answer because they cannot hold up to scrutiny in all situations.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Disclosure of medical errors is an important factor in supporting both patient safety and the patient-physician relationship. Which of the following approaches is recommended to facilitate an effective disclosure?<\/span><\/p>\n<p><span style=\"color: #f6222a\">A. <span style=\"font-weight: 400\">Always delay the disclosure until all details of the event have been investigated<\/span><\/span><br>B. <span style=\"font-weight: 400\">Include a representative from the risk management team in the disclosure<\/span><br>C. <span style=\"font-weight: 400\">Limit the discussion only to the individual event being disclosed<\/span><br><span style=\"color: #f6222a\">D. <span style=\"font-weight: 400\">Never use language that includes an explicit apology<\/span><\/span><\/p>\n<p><span style=\"color: #f6222a\">A and D contain absolute terms &#8220;always&#8221; and &#8220;never.&#8221; These should be avoided in answer choices because they are less likely to be true statements.<\/span><\/p>\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p>4. Keep an eye out for a <strong>long correct answer<\/strong>.<\/p>\n\n\n<p><span style=\"color: #f6222a\"><strong>Long correct answer<\/strong><\/span>: the correct answer is longer, more specific, or more complete than the other options.<\/p>\n<p><span style=\"font-weight: 400\">A 7-year-old boy is being evaluated for ongoing periumbilical abdominal pain that has failed to respond to supportive measures alone. The initial history is benign and the physical examination does not reveal any abnormalities, but the child has missed multiple days of school due to the pain, and his parents are increasingly concerned about his well-being. They would like to discuss the next steps in evaluating him for an underlying cause, and in particular, ask whether a CT of the abdomen should be ordered. Which of the following is the most appropriate next step?<\/span><\/p>\n<p><span style=\"color: #48952c\">A.<\/span> <span style=\"color: #48952c\">Educate the family on the possible contributions and drawbacks of diagnostic studies, and present alternate management options<\/span><br>B. <span style=\"font-weight: 400\">Order a CT scan of the abdomen<\/span><br>C. <span style=\"font-weight: 400\">Reassure the parents that nothing serious is wrong<\/span><br>D. <span style=\"font-weight: 400\">Recommend behavioral therapy <\/span><\/p>\n<p>Option A is longer than the other options, and it is also the only double option. Item writers tend to pay more attention to the correct answer than to the distractors and write long correct answers that include additional instructional material, parenthetical information, and caveats.<\/p>\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p>5. Notice when a <strong>word repeats<\/strong>.<\/p>\n\n\n<p><span style=\"color: #f6222a\"><strong>Word repeats<\/strong>:<\/span> a word or phrase is included in the stem and in the correct answer.<\/p>\n<p><span style=\"font-weight: 400\">A 13-year-old obese boy presents with a progressive left-sided limp over the past three weeks. The patient states that he has pain in his knee. On exam, you elicit pain on internal rotation of the hip. <\/span><span style=\"font-weight: 400\">Plain radiographs show a left hip joint abnormality \u201clike ice cream <\/span><span style=\"font-weight: 400;color: #48952c\">slipping<\/span><span style=\"font-weight: 400\"> off a cone.\u201d<\/span><span style=\"font-weight: 400\"> Which of the following is the most likely diagnosis?<\/span><\/p>\n<p>A. <span style=\"font-weight: 400\">Greater trochanteric bursitis<\/span><br>B. <span style=\"font-weight: 400\">Legg-Calv\u00e9-Perthes disease<\/span><br><span style=\"color: #48952c\">C. Slipped capital femoral epiphysis<\/span><br>D. Transient synovitis<\/p>\n<p><span style=\"font-weight: 400\">This question uses the term \u201cslipping\u201d in the question stem, and \u201cslipped capital femoral epiphysis\u201d is the correct answer.<\/span><\/p>\n\n\n<hr class=\"wp-block-separator\"\/>\n\n\n\n<p>Taking the time to identify your unknown unknowns will not only help you prepare for and excel on your exam, it will help you expand your core knowledge. Then, on test day, use the five simple techniques to identify common flaws in questions which will increase your chances of getting a question correct.<\/p>\n\n\n\n<p><span>Give these methods a try and let me know how it goes. Moreover, I\u2019d love to hear about techniques you use that I did not write about.<\/span><\/p>\n\n\n\n<p><span>And if you are&nbsp;looking for a <a aria-label=\" (opens in a new tab)\" rel=\"noreferrer noopener\" href=\"https:\/\/www.roshreview.com\/specialties\/pediatric-medicine\/\" target=\"_blank\">pediatric board review Qbank<\/a>&#8230;you know where to find one. <\/span><\/p>\n\n\n\n<p>Best,<br>Morgan Leafe, MD<\/p>\n","protected":false},"excerpt":{"rendered":"<p>We already know pass rates for the ABP exam hover around 85% for all test-takers. This article is going to show two very easy ways to help increase your Pediatrics Certification score by 50 points.\u00a0While there is no magic pill or wand to achieve this, these two techniques are the most useful, easy to implement and only requires a little of your time. This means anyone can take advantage of them. The first tactic is to use a system over a couple of months to identify what you don&#8217;t know. Sounds easy, right? The key is to go through a curriculum and identify what you don&#8217;t know &#8211; not what you are weak at &#8211; but what you don&#8217;t know. The second strategy is to take advantage of human error. Tests are written by humans, of course, and humans make errors. This article will show you 5 very easy techniques to narrow down an answer choice to either the correct answer or to a 50\/50 probability &#8211; even without knowing anything about the topic. By combining these two strategies, you&#8217;ll be able to increase your Pediatrics certification score by 50 points &#8211; which could be the difference between passing or failing. Let&#8217;s get started.<\/p>\n","protected":false},"author":42,"featured_media":11737,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[1996,2013,2002],"tags":[2058,2269,2953,3803,3708],"coauthors":[3854],"class_list":["post-1889","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blogtype","category-pediatrics","category-study-strategies","tag-abp","tag-board-exam","tag-learning-system","tag-pediatrics-board-exam","tag-unknown-unknowns"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v21.7 (Yoast SEO v26.6) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How to Increase Your Pediatric Board Exam Score - RoshReview.com<\/title>\n<meta name=\"description\" content=\"These two strategies are easy to do and can help increase your Pediatric Board Exam score. 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