Psychology of the classic UW question.

[DocSikorski]

I did like 30% of the UW (CK) and improved greatly from the first few tests.
I am still fresh from taking step 1 and remember many UW (Step 1) questions.

This time I kinda feel that UW is harder in matter of many questions being "splitting-hair-like".

Step 1 was exactly opposite - whenever you see a split-hair answer options - it is time to read the question again, because these options are more likey wrong...

We have many questions here that are "what is the best next step in treatment or diagnostics" but also there are a ton of Step-1-like questions.

Or maybe it is step 1 that has many CK questions these days?

==================

this post is completely theoretical, UW is the first q-bank that I am doing and still according to the most polls - UW is the best.
But if I have many split-hair questions, I tend to get many of them wrong...

How are you guys feeling about CK format? What is the key-issue to address while reading the explanations?

[d_wiqed]

Originally Posted by DocSikorski

How are you guys feeling about CK format? What is the key-issue to address while reading the explanations?

Hi, DocSikorski!

True... Most of the choices in management are correct or are very close to one another, the problem is in deciding which one is the "best" answer. For me, the CK format is a bit more vague or in the gray areas than step 1. (I'm doing Kaplan qbank right now though. I'm not yet in UW...)

In my humble opinion (as a "step 2 newbie" -- lol!), the key issue to address while reading the explanation is the "why". Why this diagnosis and why this management? What are the clues in the vignette that pointed to the right answer. Also, it's easier to take notes when I focus on these...

P.S.
It's your 1,000th post. lol!!

[DocSikorski]

Here is one q from UW that is discouraging.
But if you think about it - it makes perfect sense though...

Old guy, fatigue and dyspnea. No chest pain, syncope or edema. Acute MI one month ago.
Bilateral crackles in the lower chest. Pansystolic murmur at the apex with radiation to axilla. ECG - unchanged Q wave and persistent ST elevation in anterior leads. Whats the cause?

a. Septum rupture
b. free wall rupture.
c. pulmonary infarct
d. recurrent ischemia
e. acute pericarditis.
f. aortic dissection
g. papilary muscle rupture
h. acute pericarditis
i. ventricular aneurism


Lets discuss this one.
I find it interesting that i was among 61% of people who chose the wrong aswers and only 12% chose the right one... Probably those who did UW 2 times lol...

[Novobiocin]

persistent ST elevation= ventricular aneurysm

[DocSikorski]

noticed one thing.
There are many distractors in Step 2. You see tons of buzzwords that might be a giveaway in step 1 but now they are just working against you!

[d_wiqed]

Argh! Yep. The questions are also sooo long! My attention span wears off in reading just 1 question! Can't imagine going through the whole exam.

The pertinent info gets buried in the distractors too.

[drsmart]

Originally Posted by DocSikorski

Here is one q from UW that is discouraging.
But if you think about it - it makes perfect sense though...

Old guy, fatigue and dyspnea. No chest pain, syncope or edema. Acute MI one month ago.
Bilateral crackles in the lower chest. Pansystolic murmur at the apex with radiation to axilla. ECG - unchanged Q wave and persistent ST elevation in anterior leads. Whats the cause?

a. Septum rupture
b. free wall rupture.
c. pulmonary infarct
d. recurrent ischemia
e. acute pericarditis.
f. aortic dissection
g. papilary muscle rupture
h. acute pericarditis
i. ventricular aneurism


Lets discuss this one.
I find it interesting that i was among 61% of people who chose the wrong aswers and only 12% chose the right one... Probably those who did UW 2 times lol...

aneurysm! getting dilatin causing the pan systolic murmur ecg features as said ST elevation. crackles are from the murmur due to come pulmonary congenstion

[DocSikorski]

Originally Posted by d_wiqed

Argh! Yep. The questions are also sooo long! My attention span wears off in reading just 1 question! Can't imagine going through the whole exam.

The pertinent info gets buried in the distractors too.

yes. questions are super long in UW too.
Never came across at least 3-line question yet.
But what I do most of the time - read first sentence, last sentence and than - answer options, i'd say in 40% questions it is enough, which is not too bad.

[DocSikorski]

question id: 2748 is a freaking instagram!

[DocSikorski]

I kinda feel that a good number of UW questions is very unfair...

Here is a good example:

36-old guy has acanthosis nigricans. What a physician should suspect in him?

a. gi malignancy
b. diabetes
c. hemorrhoids
d...

[Novobiocin]

I think the whole purpose of UW questions is to hammer a concept into our head.
In the above example, the concept they want to hammer home is:

Acanthosis nigricans in a young patient= Diabetes

Acanthosis nigricans in an old patient= malignancy

[DocSikorski]

Right, but honestly, did you know that before you encountered this q?

This only prooves the fact that UW is a learning tool, I guess...

[DocSikorski]

"Referral to a specialist"

is usually correct answer in step 2 ck and also a synonym to a "perform appropriate procedure"

[Novobiocin]

Originally Posted by DocSikorski

Right, but honestly, did you know that before you encountered this q?

This only prooves the fact that UW is a learning tool, I guess...

No, I didn't know before and, yes, UW is a learning tool but it also helps to assess your learning as you go along. For example, if someone has done 20% of UW at 55% average and by 40% of UW the percentage has not gone up to 60% then they should reassess their strategy.

UWSA is the assessment tool.

[K06100]

M done with UW.......thank god ...its finished.......Now m feeling Good

[Novobiocin]

Originally Posted by DocSikorski

question id: 2748 is a freaking instagram!

Originally Posted by K06100

M done with UW.......thank god ...its finished.......Now m feeling Good

Now try UW QID:8472

[K06100]

Originally Posted by Novobiocin

Now try UW QID:8472

I tried it ...got wrong.......I think its a new question they just added a day before

[Novobiocin]

Originally Posted by K06100

I tried it ...got wrong.......I think its a new question they just added a day before

I got it wrong too.........it's fit for cardiology boards......I wonder how 19% people got it right.
It was the only question I found which was "unused" and my % on this "Block of 1" was 0% .............Today I hit "Rock bottom".

[K06100]

Originally Posted by Novobiocin

I got it wrong too.........it's fit for cardiology boards......I wonder how 19% people got it right.
It was the only question I found which was "unused" and my % on this "Block of 1" was 0% .............Today I hit "Rock bottom".

exactly same with me........I got 0/1 (0%)......

[d_wiqed]

Originally Posted by K06100

M done with UW.......thank god ...its finished.......Now m feeling Good

That's great!! Congrats!

[drsmart]

Originally Posted by Novobiocin

I got it wrong too.........it's fit for cardiology boards......I wonder how 19% people got it right.
It was the only question I found which was "unused" and my % on this "Block of 1" was 0% .............Today I hit "Rock bottom".

it is the one of easiest questions, AF is so common that its a banker question really,

even if u didnt know it you could work it out,
comes from pulmonary veins, thats why they do pulmonary vein isolation for treatment of AF

[DocSikorski]

Originally Posted by drsmart

it is the one of easiest questions, AF is so common that its a banker question really,

even if u didnt know it you could work it out,
comes from pulmonary veins, thats why they do pulmonary vein isolation for treatment of AF

cmon, even my dog knows that...

[step_enhancer]

Originally Posted by drsmart

it is the one of easiest questions, AF is so common that its a banker question really,

even if u didnt know it you could work it out,
comes from pulmonary veins, thats why they do pulmonary vein isolation for treatment of AF

Then why only 19% knew the answer !

[drsmart]

Originally Posted by step_enhancer

Then why only 19% knew the answer !

because they didnt use their brain,

[DocSikorski]

In the questions where you pic most appropriate answer option by your opinion and get it wrong, but you see that the majority got it wrong and like 19% got it right - it means that those good 10-15% are the people who did UW more than once (other 4% blindly guessed).

this makes an interesting conclusion:

UW average score can be lowered by 15% when you evaluate yourself.

My average now is 60% and the percentile is 30.

This means that I am still at 60% (not 75) but my percentile should be actually higher.

Some of you who have 70% average now - tell me, what your percentile is please! So I can actually estimate what mine is.

-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-

People who made it through Step 1 are most likely to use UW again for CK based on their success with step 1. This means that UW score first time is a great evaluating tool! But we have to recalculate percentiles to be specific.

[step_enhancer]

The average uworld score is around 60 % ,which means it correlates approx to the usmle step 2 ck mean which is around 235.

So if somebody has 60% in uworld ,he might be 235 +/- 10 depending on the exam he gets/his performance .I took NBME and I found clinical judgement Qs ,which requires a good clinical acumen (cannot be attained by doing UW or MTB).
So it depends what kind of exam one gets ,his/her strengths and last month preparation .

[drsmart]

Originally Posted by DocSikorski

In the questions where you pic most appropriate answer option by your opinion and get it wrong, but you see that the majority got it wrong and like 19% got it right - it means that those good 10-15% are the people who did UW more than once (other 4% blindly guessed).

this makes an interesting conclusion:

UW average score can be lowered by 15% when you evaluate yourself.

My average now is 60% and the percentile is 30.

This means that I am still at 60% (not 75) but my percentile should be actually higher.

Some of you who have 70% average now - tell me, what your percentile is please! So I can actually estimate what mine is.

-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-

People who made it through Step 1 are most likely to use UW again for CK based on their success with step 1. This means that UW score first time is a great evaluating tool! But we have to recalculate percentiles to be specific.

i think its tru about the second round and the guesses but ur over estimating it.

ppl would know this, but medicine is pretty massive that some ppl will know different stuff to others and depending on your interests u would read more, but still its an easy qns because pulmonary vein isolation is a treatment for AF therefore by reasoning u could get this or you would guess this if u werent quite sure

really does it give you 30% percentile for 60! that cant be right

mine now is 76%, 86 percentile.

[DocSikorski]

Originally Posted by drsmart

i think its tru about the second round and the guesses but ur over estimating it.

ppl would know this, but medicine is pretty massive that some ppl will know different stuff to others and depending on your interests u would read more, but still its an easy qns because pulmonary vein isolation is a treatment for AF therefore by reasoning u could get this or you would guess this if u werent quite sure

really does it give you 30% percentile for 60! that cant be right

mine now is 76%, 86 percentile.

yup, 30th percentile

[theundead]

I'm one of those who are doing uworld online after completing it once offline, & i wouldnt have gotten that AF question right without having read about it here first.(strange coincidence, i read it here & in the next block i do, i get that question)
imo there's a 20% chance one would randomly pick the right answer out of 5, & this explains the 19% of ppl who got it right

[DocSikorski]

"Reassurance and Observation"

both seem to be the right answer in most of the questions offering it as an option.
The take home message is to learn not to overtreat the patient I guess.