How do I stop choking??

[PillsburyDoughBoi]

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[Oso]

Sounds like you're studying well and doing well on the practice tests. Only thing I can think of is maybe some testing anxiety, especially now that you're consciously worried about your performance on the shelf. Do you think this could be contributing at all?

 

[operaman]

A few possibilities:

1) there is no difference in your scores and you are misreading the scoring metric they give you. The consistent drop across shelves suggests this may be an issue. The ones you can buy via the nbme are scored differently but I don’t remember the details, so be sure you’re comparing apples to apples.

2) you may have some underlying test anxiety causing you to make stupid mistakes on test day. This is possible. You could try better simulating actual test conditions during your prep time.

3) your scores are well within the SED for the scales give. This is one of the best openly published secrets of the NBME. At least for Step 1, two scores must differ by at least 16 points in order to be significantly different. As far at the nbme is concerned, a 240 and a 250 are not significantly different and could easily be explained by random fluctuations. Obviously that isn’t how most people view them but it’s how they’re scored. All you can do is study as hard as you can and put in your best performance possible.

 

[NeurologyHopeful2018]

A few possibilities:

1) there is no difference in your scores and you are misreading the scoring metric they give you. The consistent drop across shelves suggests this may be an issue. The ones you can buy via the nbme are scored differently but I don’t remember the details, so be sure you’re comparing apples to apples.

2) you may have some underlying test anxiety causing you to make stupid mistakes on test day. This is possible. You could try better simulating actual test conditions during your prep time.

3) your scores are well within the SED for the scales give. This is one of the best openly published secrets of the NBME. At least for Step 1, two scores must differ by at least 16 points in order to be significantly different. As far at the nbme is concerned, a 240 and a 250 are not significantly different and could easily be explained by random fluctuations. Obviously that isn’t how most people view them but it’s how they’re scored. All you can do is study as hard as you can and put in your best performance possible.

That's scary to think about - if I am actually scoring 240 baseline - then random fluctuations could mean I either get a 232 or a 248 based on luck?

 

[operaman]

That's scary to think about - if I am actually scoring 240 baseline - then random fluctuations could mean I either get a 232 or a 248 based on luck?

Not exactly, but close. Remember this is all based on probability - we all dreaded getting a form that randomly hit all our weaknesses, so I think we intuitively get that there are fluctuations. For most, the law of averages will ensure they score pretty darn close to their pre test scores assuming they were done under testlike conditions.

I think the message is not to obsess about small differences in scores. You’ll see posts where someone drops from a 245 to a 235 and wonders what went wrong - may just be random chance. The better scenario is the opposite - jumping 10 points and taking that to mean your prep is effective. Could also mean you’re maintaining and hitting a plateau. All has to be taken in context with your own comfort and facility with the material.

In the end, step 1 was designed as a test of minimum competence and not as a means to distinguish applicants. It’s sad that it’s used this way and perhaps one day to usmle will respond by changing the exam to allow more fine distinctions between applicants.

 

[TheIllusionist]

Not exactly, but close. Remember this is all based on probability - we all dreaded getting a form that randomly hit all our weaknesses, so I think we intuitively get that there are fluctuations. For most, the law of averages will ensure they score pretty darn close to their pre test scores assuming they were done under testlike conditions.

I think the message is not to obsess about small differences in scores. You’ll see posts where someone drops from a 245 to a 235 and wonders what went wrong - may just be random chance. The better scenario is the opposite - jumping 10 points and taking that to mean your prep is effective. Could also mean you’re maintaining and hitting a plateau. All has to be taken in context with your own comfort and facility with the material.

In the end, step 1 was designed as a test of minimum competence and not as a means to distinguish applicants. It’s sad that it’s used this way and perhaps one day to usmle will respond by changing the exam to allow more fine distinctions between applicants.

+100. It's a good screen for incompetence and a poor one for excellence. Too much of the latter on there relies on brute memory skills over reasoning prowess. Yes the latter matters but it is hardly the rate limiting step to ones success on there.