I recommend people write test questions as they prepare for their exams. It gets you inside the heads of the test writers. Tara sent me this one.
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“A 25-year-old sexually active female comes into your office complaining of lower abdominal pain and reports she hasn’t had her period in 2 months, what would you order?”
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This is a great question. It forces you to move through a differential diagnosis and defend your plan for what you would order and why.
She wrote this question with an ectopic in mind, but what else would be in the differential?
– Normal pregnancy
– Appendicitis
– Ovarian cyst
– Ovarian torsion
– Ruptured ectopic
– Gas
And this was the point of the question. What would you order to help you decide on the best way to treat this patient?
The next step in writing the question comes when you also have to write the answers. It makes it much more difficult and brings you even deeper into the mind of the test taker. Let’s say you wrote this same question as multiple-choice question instead of open-ended.
“A 25-year-old sexually active female comes into your office complaining of lower abdominal pain and reports she hasn’t had her period in 2 months, what is the most likely diagnosis?”
A) Normal pregnancy
B) Ectopic pregnancy
C) Ovarian Cyst
D) Appendicitis
It’s really hard to say from what we’ve got to work with. We need more information.
This is where you have to work hard and think. What would you HAVE to include in your question to make the reader know that it was each of these answers?
What I mean is, what other information would you NEED to give the reader to make it so that they can reliably choose one of these answers? Figure that out for each of the answer choices.
What would you have to include or exclude for the reader to get the right answer of normal pregnancy? What about the right answer of ovarian cyst?
How about ectopic? And what words would you have to include to point the test taker to appendicitis?
If you can come up with answers to those questions, you are going to rocking your exam. You can start to see how to wind up at the right answer and rule out everything else. The is a fundamental way of thinking and taking exams.
For more work on fundamentals, use The Final Step.
Brian Wallace
P.S. Want a free copy of the Final Step? Run a group sale for your school and you’ll get your copy for FREE. Your friends and classmates get a huge discount (thanks to the savings on shipping) and you get your book for zero dollars. It’s a total win. Hit reply and I’ll send you the details.