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I study for hours and hours, but don t get the grades I want. Why?

In a health profession school time management is a very important part of the skills that a student must possess. As a rule of thumb for every hour a student spends in class, one and a half hour of study time is needed. So, it is not surprising that you need to study for hours and hours. However, if you do not spend your time doing a “focused” study and review, then you may not do as well as you would like. A focused study/review means understanding the main ideas and concepts of the subject matter. Once you have gotten these main ideas then you can concentrate on the major details. Often students make the mistake of trying to learn and memorized everything. There is too much material and not enough time to do this. To determine what to focus on you need to:

• Attend lecture and listen closely to what the lecturer is concentrating on
• Speak to classmates and find out what they felt was the most important information in the lecture
• Read the provided notes or PowerPoint materials, reading to understand the concepts and ideas presented and start selecting out what are the most important facts, concepts and ideas
• Develop review notes that include the most important facts etc.
• Review the notes you have made to put the information into long term memory

On multiple-choice tests, I often get down to two choices, but seem to choose the wrong one. What can I do about this?

First, you should check that you are in the right ballpark. In other words, of the two answers you consider are right does one of them consistently (70%-80% of the time or better) turn out to be the right answer when you check the exam answer key. For example, you think answers “A” and “C” may be correct, and after checking the key the answer is “C”, then you are in the right ballpark. However, if the answer is”D” then you were not even close to being in the ballpark. Now if you are consistently choosing two answers with a 70%-80% or better accuracy and yet still not getting the right answer that much, here is simple strategy to improve your getting the correct answer.

• First, remember that you are looking for the BEST answer, not the correct answer. All of the potential answers could be correct (for instance, five antihypertensive drugs) but the BEST one is that which uses the information in the question, which is usually based on a specific set of facts or data.
  
• The facts or data often presented in the question can run the spectrum from history, physical exam, diagnostic tests, x-rays etc. Your job is to evaluate those facts to arrive at the BEST answer related to them. The problem is that there is not always one clear-cut answer; in fact, much of the time there are two (maybe three) answers that seem the BEST. What often happens at this point is that the student starts “ping-ponging” between the two answers that are left. They start comparing the two answers to each other “Answer A does this, but so does Answer B; but Answer B can also do this and Answer A can too”. This leads nowhere.
  
• So what do you done when you are down to two choices? A simple method is to pick one answer and go through the data points one at a time and see if they prove or disprove that answer is BEST or not.

For instance, Answer A is the antihypertensive drug hydrochlorothiazide, and Answer B is atenonol, a beta-blocker antihypertensive. Both drugs are used with hypertension, so the question must be asking which drug to use for a particular reason. The question states that “An 87-year-old male has been diagnosed with mild hypertension, which is the best treatment?” Now the data points are: Age 87; Gender Male; and Mild hypertension. So to find the BEST answer let s select Answer B, atenonol and prove if it is BEST or not. The first data point is age 87. Is atenonol the BEST drug to use for an elderly patient? The answer is NO; it is not as effective in elderly patients, so the BEST answer is hydrochlorothiazide, which is very effective in elderly patients. The other two data points, gender and mild hypertension relate to both answers and do not prove or disprove either answer is BEST.