Most physicians recognize the importance of mastering multiple-choice questions for board exam success. These questions are a cornerstone of medical board exams and offer a reliable way to gauge your specialty knowledge.
Taking multiple-choice tests is a preferred study approach because it simulates the exam format, helps physicians identify their knowledge gaps, and improves their test-taking skills. Even more, success on practice tests can boost confidence and reduce test-day anxiety.
While multiple-choice tests are a valuable tool for preparation, it’s important to supplement them with other study methods, such as reviewing high-yield topics in current, comprehensive board review books, online resources, medical podcasts, and practicing clinical scenarios.
In a 2022 study, an Error Reflection Method (ERM) was developed to help medical students focus on ‘why’ they got an MCQ wrong rather than ‘what’ they got wrong, thereby promoting self-reflection and learning that focused on assessment.
FOCUS on ‘Why’, not just ‘What’
It’s typical to look for WHAT you missed on practice tests. However, figuring out WHY you missed it requires more self-reflection and analysis. Recall your reasoning: why did you choose the incorrect answer? Did you make any biases or assumptions? Did you use effective strategies to eliminate incorrect options?
The ideal approach is to relearn the information in such a way as to make it meaningful and memorable–to make it “stick” in long-term memory.
Five Strategies to Turn Your Errors into Triumphs
(1) Test first. Find out what you know and don’t know. While you may not feel ready to test yourself, do it anyway. It’s actually a more efficient way to learn. Focus on high-yield topics from the exam blueprint and prioritize your study efforts accordingly.
(2) Identify your knowledge gaps. Determine the topic–what subject matter was the question related to? Assess your understanding–do you have a firm grasp of the concepts involved? Identify missing information–was there any key detail you overlooked?
(3) Self-reflect and learn ‘what’ was missed and ‘why’ you missed it. Figure out what in the answer options led you astray. Re-read the question carefully. Examine the correct answer–why was it the correct choice? Analyze the incorrect options–what made them seem plausible.
(4) Retest using active recall. Test yourself regularly by using flashcards or quizzes to reinforce your understanding of the material. Avoid passive learning strategies like re-reading or highlighting, which are leas effective for long-term retention.
(5) Identify the types of errors you are making using the ERM Framework (below). Are you making test-taking errors and/or learning behavior errors? Periodically assess your testing errors so that you can take the appropriate action.
USE the ERM framework to Enhance Your Learning
The table (below) was developed as part of the ERM that medical students used to improve their self-reflection on learning-behavior deficits. Physician learners at all levels can use this to aid their learning.
In this study of nearly 4,000 M1 and M2 students, the majority of errors were Learning-behavior errors (Types 5-9)–with the largest percentage (30%) represented by Type 7 Error, followed by Type 8 Error (< 20%).
As a result of using the ERM method, students were surprised at the number of test-taking errors they made, and their anxiety about making errors diminished.
So, how can this information be helpful to those preparing for medical specialty boards?
When you review your missed questions, use the ERM framework to analyze ‘why’ you missed the questions.
Use the ERM with daily testing or more extended monthly practice tests to assess and inform your preparation. For questions you repeatedly miss, create a flash card or a question card to record specific data about the question, the distractors and why they’re incorrect, and the answer and why it is correct.
Don’t leave your board exam preparation to chance. Like many of your colleagues, dedicate a substantial portion of your study time to honing your skills with multiple-choice questions.
Remember, learning ‘what’ you missed is important but going a step further and reflecting on ‘why’ you missed it, can help prevent your making these mistakes in the future and boost your board score.
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