is uworld like step 1 with ordering of answer choices?

[njmedstudent87]

i'm asking because when doing uworld questions i've instinctively become accustomed to knowing when they are trying to trick me with a question because they will most often list the answer choice that is wrong and most obvious first....and it kind of messes me up because even if i don't know the answer to a question i can many times tell it is not the obvious one.

i don't want to come on test day and start doubting every answer choice I have....

on the steps are the answers alphabetical or are they placed in the tricky order uworld does it like?

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[Rabbit Hole]

They're usually placed in alphabetical order. In fact, there is an entire guide/format that has to be followed by people who write the USMLE questions so it is consistent.

Here is the guide:
Constructing Written Test Questions For the Basic and Clinical Sciences

A gem from pg27

General Guidelines for Item Construction

• Make sure the item can be answered without looking at the options OR that the options are 100% true or false.

• Include as much of the item as possible in the stem; the stems should be long and the options short.

• Avoid superfluous information.

• Avoid “tricky” and overly complex items.

• Write options that are grammatically consistent and logically compatible with the stem; list them in logical or alphabetical order. Write distractors that are plausible and the same relative length as the answer.

• Avoid using absolutes such as always, never, and all in the options; also avoid using vague terms such as usually and frequently.

• Avoid negatively phrased items (eg, those with except or not in the lead-in). If you must use a negative stem, use only short (preferably single word) options.

And most important of all: Focus on important concepts; don’t waste time testing trivial facts.

A gem from pg34

The Basic Rules for One-Best-Answer Items

• Each item should focus on an important concept, typically a common or potentially catastrophic clinical problem. Don’t waste testing time with questions assessing knowledge of trivial facts. Focus on problems that would be encountered in real life. Avoid trivial, “tricky,” or overly complex questions.

• Each item should assess application of knowledge, not recall of an isolated fact. The item stems may be relatively long; the options should be short. Clinical vignettes provide a good basis for a question. For the clinical sciences, each should begin with the presenting problem of a patient, followed by the history (including duration of signs and symptoms), physical findings, results of diagnostic studies, initial treatment, subsequent findings, etc. Vignettes may include only a subset of this information, but the information should be provided in this specified order. For the basic sciences, patient vignettes may be very brief; “laboratory vignettes” are also appropriate.

• The stem of the item must pose a clear question, and it should be possible to arrive at an answer with the options covered. To determine if the question is focused, cover up the options and see if the question is clear and if the examinees can pose an answer based only on the stem. Rewrite the stem and/or options if they could not.

• All distractors (ie, incorrect options) should be homogeneous. They should fall into the same category as the correct answer (eg, all diagnoses, tests, treatments, prognoses, disposition alternatives). Rewrite any dissimilar distractors. Avoid using “double options” (eg, do W and X; do Y because of Z) unless the correct answer and all distractors are double options. Rewrite double options to focus on a single point. All distractors should be plausible, grammatically consistent, logically compatible, and of the same (relative) length as the correct answer. Order the options in logical order (eg, numeric), or in alphabetical order.

• Avoid technical item flaws that provide special benefit to testwise examinees or that pose irrelevant difficulty.

Do NOT write any questions of the form “Which of the following statements is correct?” or “Each of the following statements is correct EXCEPT.” These questions are unfocused and have heterogeneous options.

Subject each question to the five “tests” implied by the above rules. If a question passes all five, it is probably well-phrased and focused on an appropriate topic.

 

[AggieSean]

I wish our professors would read this.

 

[username456789]

I wish our professors would read this.

Seriously.

One of the heads of the Medical Education Department here even said, when speaking to us about Step I vs. in-house exams, "The Step I questions aren't usually trying to trick you . . . you either know it your don't, but the options will usually be different enough that there's no ambiguity. Our exams here tend to focus a lot on small tricky details."

Stupid.

 

[AggieSean]

Reading through that list, our profs do so many of the things it says NOT to do. So glad I'm done with that now.

 

[kryptik]

"Professors primary duty is to teach you medicine to become a good physician, not to make you a good test taker", thats what one of my professors said when we brought this topic up once in class

 

[Raryn]

They're usually placed in alphabetical order. In fact, there is an entire guide/format that has to be followed by people who write the USMLE questions so it is consistent.

Here is the guide:
Constructing Written Test Questions For the Basic and Clinical Sciences

A gem from pg27
A gem from pg34

Oh my, if our professors used those rules, 99.99% of our disputed questions on the exams would disappear overnight.

 

[Rabbit Hole]

One of the reasons Step 1 is so challenging is because we have to get out of the mindset of thinking the questions are trying to trick us. That's why doing UWorld and NBME exams is so important - training tools to approach USMLE questions the right way.

 

[username456789]

"Professors primary duty is to teach you medicine to become a good physician, not to make you a good test taker", thats what one of my professors said when we brought this topic up once in class

Did he/she care to explain how focusing on obscure minutiae brought you all closer to that goal?

It seems to me that on a grand scale, preparing someone for Step I is more clinically relevant than preparing someone for most in-house exams. Obviously neither will suddenly make you a great clinician, but look at how the Step I question makers are told to focus on IMPORTANT CONCEPTS.