How do you focus on something that's driving you up the wall?
March 12, 2017 2:20 PM   Subscribe

I have to take a test for my overseas nursing registration. As an advanced practice nurse from the US, the level of training and education I've had is far beyond what is required of me for this test. I have a 1,000 page manual of basic nursing procedures to memorize. How do I cram it all in and suppress my critical-thinking brain and hone my test-taking brain?

I've never been a great test-taker, as I tend to get thrown by inconsistencies in questions and I want to think critically about them, rather than answering the "right" answer that the test wants. But, I know from the sample questions that this test is multiple-choice and will require memorization of lots of niggling processes and a brain in test-taking mode. For example, while I have many years of experience, lots of things (e.g., how to put a patient into bed) are innate to me, but the test might penalize me if I choose the wrong order. (To generalize, if a question asked me about making a sandwich, I might be penalized if I choose to put the mustard on below rather than above the lettuce, which is not actually incorrect in real life but is not the "approved" method per the technical manual). What tips or tricks can you share for how to prepare and study for something like this? I am trying to go through the manual systematically but it is quite dry and I am finding any excuse not to read through it. I have tried setting a timer but I even run away from that! The last test I took was my national board exam in the US, which required a totally different set of study skills and approach.

I should add that no practice tests are available, but if I fail, I will be given the opportunity to re-take the test one month later. The organization that runs the test offers no guidance or assistance, and there are no third-party prep services or study guides.
posted by pocksuppeteer to Grab Bag (11 answers total) 4 users marked this as a favorite
I don't know if this would work for you, but what I'd do is this: write notes in the form of an exam. As you read the book, it'll help you picture what points the examiners are most likely to fix on.
posted by zadcat at 2:33 PM on March 12 [1 favorite]

Are any of the materials you have available in eBook or PDF form? Are you near a place that can scan the materials?

I have a lot of trouble focusing on really boring stuff I have to memorize. I find some way to make the materials digital and OCR'ed and use an eBook reader app and Text-To-Speech to read the material to me while I go for a walk or while commuting.

Depending on the format of the questions, this varies in its utility. Multiple choice questions can be difficult because then I remember the wrong answers too, unless there's an explanation.
posted by MonsieurBon at 2:46 PM on March 12

I'm not much of a rote memorizer either but spaced-repetition with Anki has gotten me through pre-med and two years of med school. Make flashcards as you read and review them every day. Don't give yourself any leeway when you review your flashcards -- if you don't get the exact answer the card was looking for, it was wrong, and you need to review it again. You've got this.
posted by telegraph at 2:46 PM on March 12 [7 favorites]

Do you do teaching in your advanced practice role? Could you approach answering these questions not with a view to "what would I do in this situation," but "what would I want to see a student or novice nurse do in this situation"?

Do you have access to enough sample questions to look at them critically as a group and try to get an idea of what the test-writers' priorities are? (Maybe you have already done this, since you mention the basic, correctly-ordered procedures...) How does answering sample questions feel when you approach them through the lens of "the test-writers would prioritize...." I'm a student nurse in an entry-to-practice MScN program, and am just about to start studying in earnest for the NCLEX. When I do practice questions, I find that I get in trouble because my program has a strong emphasis on patient/family centred care and attending to psychosocial issues, whereas in NCLEX-land the physical assessment or intervention is always the priority, even if a psychosocial issue looks more urgent to me coming from my training. Thinking about the test-writers' priorities seems helpful to me so far.
posted by snorkmaiden at 2:55 PM on March 12

That sounds like an incredible pain in the ass, if you're having to essentially memorize metadata about stuff you already know, and it sounds as though standard study materials aren't going to be adequate for your particular needs.

Could you make up some sort of code that expresses just those more arbitrary things you wouldn't automatically think of for each section of the manual, and then memorize just those codes?
posted by XMLicious at 3:01 PM on March 12

How much study time do you have until testing? Studying a 1,000 page manual is basically drinking from a firehouse.

Use a circular studying pattern by incrementally dividing the manual up into chapters or subjects over a period of days or weeks to cover all the material. For example, after studying through Chp 1 and 2, circle back around and review Chp 1 and 2. Then study Chp 3, and so on. This way may help you as you're seeing the material multiple times.

For step-by-step procedures, make easy acrostics to remember. Use post-it notes and highlighters, everywhere! This type of material likely requires multiple methods of study to prepare for testing. Reading, reviewing, keyword searches.

Do you have nurse or medical friends to help you? One thing that may help you would be teaching someone a subject you're having trouble with.
posted by mountainblue at 4:19 PM on March 12 [1 favorite]

+1 on making flashcards with Anki.
posted by donajo at 5:26 PM on March 12

It's also possible that familiarizing yourself with multiple choice test "hacks" might be somewhat helpful. For instance, in a four-option test, there's often a pretty obviously wrong answer. That immediately brings you to having a 33 percent chance at the right answer, even if you just blindly guess from the choices left. Often, the longest answer is the correct answer. The "C" choice is more often, if only by a slight margin, the correct answer. Sometimes a previous question inadvertently will help you answer a question later in the test. Going back and changing your answer from your initial gut feeling on a question is more often than not harmful, not beneficial. These are the sorts of things "good" test-takers know, consciously or not. (This is coming from a person who took her last test MANY years ago, so grain of salt and all that.) Good luck! You can do this!
posted by thebrokedown at 9:00 PM on March 12

I think the first thing you need to do is to convince yourself to learn stuff to pass a test - it has nothing to do with actually being a good nurse. It sounds like one of the reasons is it so hard for you to study is that is just drives you crazy that it isn't really testing how well you can the job. Keep telling yourself, the goal is to pass the exam and get on to your future. Don't try to figure out the right answer as it applies to real patients, just focus on memorizing the correct answer and try not to waste energy fighting with how stupid it all is. (Yes, it is stupid, but it is allowed to be stupid, just do whatever you have to do to pass it.)
posted by metahawk at 9:23 PM on March 12

Great test tips from thebrokedown; I would add that inserting "always" or "never" into an answer can be a test-writer's way of making a reasonable-sounding answer incorrect. Beware absolutes!
posted by Threeve at 10:18 PM on March 12

These are really great suggestions, thank you all so much. Special thanks to metahawk for your sympathy with my conundrum and my frustration with all of it. Biting the bullet is just what I need to do! And good luck with your NCLEX, snorkmaiden! I unfortunately can't approach the test as how I would teach my students because I always want them to think critically and see patients as individuals :)
posted by pocksuppeteer at 2:17 PM on March 13 [1 favorite]

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