ABA exam part 1 advice

[cara1813]

Hello all,

I am asking for any words of wisdom, advice, whatever to help. I have taken and failed the part 1 exam 4 times. I'm in the group that takes Part 1 and 2 not the Basic and Advanced. I took Jensen for the first exam, used old exam questions and ACE questions and failed. Since then I have continued using ACE questions, attended the Cleveland Clinic Review Course, used Pass Machine, used M5 along with your basic review books, question books and Miller, etc. I took a test taking course, thinking that was the issue. The last exam I walked out thinking I could not have studied any more and nothing on the test was new to me. I worked the questions thoughtfully and really thought I did the absolute best I could, yet I still failed.
I know some people will say I'm not studying enough, but I am and this exam has been hanging over my head for too long. I work as an attending and am good at my job. I have great working relationships and do a variety of cases at my hospital. I am a qualified anesthesiologist, but this test eludes me.
Can anyone shed some light on what else I can do or how I can approach this differently? I need to move on with my life once and for all. I don't want to quit medicine but I may have no choice if this keeps up.
Any advice would be appreciated.

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[No_Pain]

yikes, that must be frustrating to say the least. Have you always had problems with tests (USMLE and ITE's)? I haven't taken the ABA boards yet so take my thoughts with a grain of salt.
It sounds like your medical knowledge is probably adequate by now, so it must be how you approach the questions on the test. I tend to test well and I'm an idiot. My wife is brilliant but she couldn't get past the USMLE's. Her nerves kept getting the best of her. I dissuaded her from taking anxiolytics, but in retrospect it may have helped. She did great on q-banks and practice tests but horrible on test day.
I think why my test scores are OK, and perhaps overestimate my medical knowledge, is my approach to each question. Its hard to explain but I will start to read the question stem assuming it's a straightforward concept (think "I know this" or "I'm awesome" in your head before each) and the answer choices are almost always meant to be vague/deceiving but trust your gut - if a choice doesn't 100% tickle your fancy it's probably a decoy. What I'm trying to say is it's all about confidence. Keep your head up and show the ABA that their little tricks and traps won't fool you.

 

[cara1813]

yikes, that must be frustrating to say the least. Have you always had problems with tests (USMLE and ITE's)? I haven't taken the ABA boards yet so take my thoughts with a grain of salt.
It sounds like your medical knowledge is probably adequate by now, so it must be how you approach the questions on the test. I tend to test well and I'm an idiot. My wife is brilliant but she couldn't get past the USMLE's. Her nerves kept getting the best of her. I dissuaded her from taking anxiolytics, but in retrospect it may have helped. She did great on q-banks and practice tests but horrible on test day.
I think why my test scores are OK, and perhaps overestimate my medical knowledge, is my approach to each question. Its hard to explain but I will start to read the question stem assuming it's a straightforward concept (think "I know this" or "I'm awesome" in your head before each) and the answer choices are almost always meant to be vague/deceiving but trust your gut - if a choice doesn't 100% tickle your fancy it's probably a decoy. What I'm trying to say is it's all about confidence. Keep your head up and show the ABA that their little tricks and traps won't fool you.

Thanks for the positive words. I used to do well on standardized tests, not off the charts perfect, but I passed. At this point, walking into the test center is daunting and I try to keep calm. I do have to work on confidence, a life long problem.

 

[pjl]

Couple questions:
Do you know the material? You study a lot and have gone to courses, but do you know the material?

When you go to the test center, what is your emotional state? Are you calm, or feeling defeated? In other words, is this a state of mind issue?

Do you run out of time on questions? Is this a pattern throughout life? Some people get test accommodations which give them an additional 50% time.

This first question is the most important, and the one where preparing differently may be the answer. Doing questions and courses may not be your learning style. You may need reading with outlining after, one on one tutoring or some other method.

Second question, you may benefit from some preparation work. After 4 attempts I would seek professional help, it is worth the price.

On the third, you can obtain accommodations by undergoing some testing and discussing with the ABA. May be worth it.

If you are failing due to #1, I am glad you are failing. Before becoming board certified you need to have a great knowledge of anesthesia. You need to know the facts and details before joining the rest of us.
If the others, I think there would be no shortage of people willing to help you. Probably plenty would be able to help you on the first issue as well, but swallowing pride is important, and you have to ask for help.

 

[cara1813]

Couple questions:
Do you know the material? You study a lot and have gone to courses, but do you know the material?

When you go to the test center, what is your emotional state? Are you calm, or feeling defeated? In other words, is this a state of mind issue?

Do you run out of time on questions? Is this a pattern throughout life? Some people get test accommodations which give them an additional 50% time.

This first question is the most important, and the one where preparing differently may be the answer. Doing questions and courses may not be your learning style. You may need reading with outlining after, one on one tutoring or some other method.

Second question, you may benefit from some preparation work. After 4 attempts I would seek professional help, it is worth the price.

On the third, you can obtain accommodations by undergoing some testing and discussing with the ABA. May be worth it.

If you are failing due to #1, I am glad you are failing. Before becoming board certified you need to have a great knowledge of anesthesia. You need to know the facts and details before joining the rest of us.
If the others, I think there would be no shortage of people willing to help you. Probably plenty would be able to help you on the first issue as well, but swallowing pride is important, and you have to ask for help.

I do know my material. I have always been a good student, but the vague questions and answers throw me off, I think. I excelled when it came to straight forward questions because I knew the material, I was never a "test taker." My study style has always been to read and outline, very traditional, but after that didn't work the first two times colleagues suggested doing more questions. I have swallowed a lot of pride and tried and tried. I do not take this lightly and know I am a good anesthesiologist. But the "guess what I'm thinking" game was never my thing.
I do tend to run to of time during the first portion and have a few minutes left during the second.

 

[pgg]

A few thoughts -

1) Are you doing your practice questions under test-like conditions? This is one way people get good results with practice questions, but then get surprised with poor results on the real thing.

2) Is your question-based study active, or passive? For some people, "doing questions" means reading the question, sort of picking out an answer (but it may be that other one too) then flipping back to the key to see if they got it right, and maybe reading the explanation. This passive method of studying leads to an overestimation of score because one is left with a general gestalt of "yeah I knew that material" instead of a concrete list of correct or wrong.

A better way to study with questions is to do a small block of them at a time (5 or 10 is a manageable number), commit to ONE answer for each, then check the key. And then - most important - go back through each question and articulate why the correct answer is the best one, and why each of the wrong answers are wrong. Even if it's a simple, easy question. Even if you got it right and understand why three of the wrong options were wrong, take the time to think or read about why the other wrong (but plausible) answer was wrong.

There's a lot of value in examining the wrong answers. They aren't randomly generated. The wrong answers are carefully crafted bait, and if you don't fully understand exactly why they're wrong, that bait may appear again and catch you on the exam.

When I was studying for the written, I rarely did more than 10 in a day. It is slow, meticulous work to make it an active process, but I think it works.

3) If test anxiety is part of the problem, consider 10 or 20 mg of propranolol before each session.

 

[leaverus]

if this person passed the ITEs during residency no problem then i would think it's not a knowledge nor studying issue. it's something specific to the board exam: test conditions, test anxiety, problem with computer-based exam; maybe pacing or attention problems...best bet at this point may be seeking professional help to tease that out.

 

[Gern Blansten]

ITE's do not have a pass or fail, you are just given national percentiles.
My guess is that you are not recognizing the material that you continue to miss. You see a question that you recognize from a previous exam and rush to put the same answer you did last time, without recognizing that you keep getting the concept wrong each time it is tested because you have not figured out the small portion of the question that changes the answer. The majority of ABA questions are like that. There will be one answer that sticks out and tempts you to choose it without looking much closer. When you do look closer, you will frequently see a seemingly minor detail that flips the scenario such that the obvious answer is no longer correct. My guess is that you have missed the same concepts over and over because you are assuming you know the answer. The only way to know that is through looking at your list of keywords. However, you must be able to remember the way they asked the questions to be able to apply the knowledge gained from the key word list. I suspect your keyword list must be extensive and, therefore, daunting to dissect apart.
In addition, the number one reason people do not pass is insufficient knowledge. No easy way to say it, but it is very true. The stubborn people will continue to say that knowledge deficit is not the issue. I urge you not to be stubborn. You likely have a cursory level of understanding of the material which is the root of your inability to pass. Substantial revamping of your outside reading is the best way to fix that. If your knowledge level is close, review questions can mask a limited knowledge if you learn concepts and patterns, but cannot fix a bigger knowledge gap issue.
I suggest that you need to read, a lot. It is the only way you will be successful and the only way you can identify all of those concepts you've been getting wrong over and over for the past several years.