(This post was originally in response to a student just starting medical school, but I think its helpful for those studying for step1 just as much)
I think its best to get advice straight from the horse's mouth:
http://www.nbme.org/PDF/ItemWriting_...03IWGwhole.pdf
The particularly
highyield part is Section II:Writing One-Best-Answer Questions for the Basic and Clinical Sciences.
It is from 2003, so the out-of-date section for Step 1 is the section III about 'extended matching', which is no longer used on step 1 exams.
In terms of how to use this information, I found it helpful to study by doing practice questions. As well, it wouldn't hurt yourself to write your own questions on material you find difficult. In this way, you would begin to appreciate and understand the test-maker's framework for how they construct questions from the material you are studying. (ie Never memorize an
isolated page from First Aid or Robbins pathology). You must be integrating everything you read and annotating the margins of review books with what you read in class (which is what Goljan is famous for with his pathology textbook, Rapid Review of Pathology). The best studiers, and test-takers are able to 'synthesize and apply' if you will (I'm quoting from this NBME manual).
In other study strategies, I found at bootleg version of FirstAid 2007 in PDF format on the web. It was very helpful to use adobe's search feature to look up terms. For example, a search for the term 'edema' appears over 46 times and if you use the advanced search feature, you can scan thru the results to see edema assoc. with Kwashiokor disease and capillary fluid exchange in cardio physiology section.
That's what the boards are made of!
*Spoiler* The guide contains actual NBME practice test questions. You know, like the ones you pay $45 for
😉
Ps. I just took Step1 this week and can't seem to get my mind off it, so I thought I'd post some of my thoughts here. I've read through much of SDN, and like others, have been very appreciative of their advice and hints at questions they got on their exams. Step 1 does like to repeat questions, but BE CAREFUL, the questions I had on my exam were the exact same pictures as others, except with a
different stem. For example, I heard from others at my school about their heart sound on the exam, but everyone seemed to have a different stem and/or sound. Its just like Goljan says with the insulinoma vs. factious insulin injector story and using protein c to differentiate the two. The NBME testing org. is smart about altering questions by a few key findings each year to prevent students from having the exact same exams, which is probably a good thing. Hope this helps. I'll post my scores here once I get them back in a few weeks.
Examples of types of questions I saw on my exam, but not the real questions:
-Differential between when a disease becomes pathological (Osteogenesis Imperfecta) vs. a behavior science answer (like child abuse)
-Integration of CT/MRI with physiology was a favorite type of synthesis question that I saw (Always study physio and anatomy together). For example, arterial contraction of a blood vessel (physio) due to (drug x) at a certain anatomical location and the associated deficit.
-Drug (x) side effect + path slide + physio response of organ
-For more sample questions, I again refer you to
question stems provided for test writers (public document) that can be found in the above manual