22 May 2006

by Shirley McGlinn, M.S. & Evelyn W. Jackson, Ph.D.

So you took the standardized entrance exam for the health professions education of your dreams -- and you're unhappy with your scores. Maybe you don't understand what went wrong. You are not alone. Thousands of students take a standardized test required for the health professions more than once. Consider the comments of three students who had to repeat a high-stakes standardized test.

Ok, now it is time to take some action. It is amazing what you will be able to accomplish if you assume control to make sure you are both well informed and proficient for the challenge ahead.

What You Need To Know

• Re: The test. Understand the format, content and skills measured, and any special demands of the test.
• Re: Yourself: Know your strengths and weaknesses, related to testing, learning, and any other factors that could impact your test performance.

What You Need to Do

• Make a realistic plan.
• Be active in your preparation
• Practice
• Analyze your mistakes and make improvements
• Be test-wise on test day

You don't need to be overwhelmed with the task at hand. Just follow a systematic approach, attending to the key steps outlined above. When you know you have taken the appropriate actions to improve, you can be confident in your test performance the next time around. You can do it. Put yourself in control!

From the Students

Know the Test

Format and Content

The first step is to secure test format and content information by looking on the internet under the name of the test. Additional information on the web site may be a statement of the purpose of the test, whether it is computerized or paper/pencil test, how it is scored (if there is a penalty for guessing), and where and when it is administered. The test information is your guide to the rest of your work involved in re-taking the test.

Sample Questions

As you look at samples of the test questions, determine what content is being tested and what skills are involved in answering the questions. This assessment takes time. You may be re-reading this material several times as you seek to understand what is being tested and what skills are involved in answering the questions.

Skills

You will be expected to demonstrate a range of skills as you work through each test question. The test will assess your ability to think logically, critically, and quickly under the pressure of a time limit. A good thinker goes through the following steps quickly and in a manner that may appear automatic. Learning to become a good critical thinker, however, may require you to dissect the thinking process and pay attention to some of the component steps. Some of the things you will need to do to demonstrate your thinking skills on the test include:

• recognize exactly what the question is asking
• predict or generate hypotheses
• gather information from your background knowledge, the question stem or accompanying passage information
• analyze information
• synthesize information
• apply information
• make a decision about your answer choice or guess and go on

Remember that understanding the demands of the test is essential. If you have questions about the test, contact the sponsoring agency and get clarification as you do your work.

Know Yourself

An in-depth and realistic assessment of your background knowledge, formal coursework, skills, and attitudes needs to be completed. No one knows how much you have learned better than you. The key word is "learned." Anyone can tell what courses you have taken or what grades are on your record; your transcript reveals that information. However, there may be a gap between what the record indicates and what you really possess as knowledge and skills.

• Knowledge. Your base has been built over the course of your life through in-school and out-of-school experiences. You learn in a number of ways and there is no substitute for first-hand, direct experience. However, it is through reading that most people build a background of knowledge. The more widely you have read, the broader your knowledge base. The more you have read about any subject, the deeper your knowledge base is in that subject. Part of your preparation is to continue to build your knowledge base. No matter how deep or broad you consider it to be, it is critical that you read widely and often.
• Coursework. Be fair to yourself and take the test only after you have completed all the requisite courses in a manner that equipped you to know the requisite information. You may need to repeat some classes before you think of retesting.
• Skills. Standardized test items are designed to assess your proficiency in a number of skills. An important part of knowing yourself is to have accurate insight into your command of these skills. It is important at this point to determine whether you need to invest in improving them.
• Attitudes. Assume you have the skills and background knowledge needed for the test. If your test score is not a reflection of that learning, you may need to examine your attitudes, the messages you give yourself. Have you set yourself up for failure? Give yourself positive messages so that you can approach and manage the exam with confidence and a sense of security that you will be all right.

Were you honest with yourself when you did your self-assessment? This is the question you must confront. You must be realistic about your readiness to perform on any test. Once you have made the assessment you are ready to make YOUR plan.

Make a Realistic Plan

A realistic and sensible plan to guide your time and preparation is a necessity. What you learned about the demands of the test as well as what you gleaned from your self-assessment will help you determine what you need to do. The following are elements that should be included in a self-directed plan:

• A timeline that will allow you to get ready. Look at the big picture and then break your preparation into smaller chunks that may seem more manageable.
• A calendar or daily planner to schedule in time for study, review, practice and self-assessments.
• An outline of how you intend to accomplish your task. (See preparation)
• A suitable place to work, one that is available and where you can concentrate.
• Commercially available content review materials and test manuals that can help you organize your preparation.

If you have difficulty keeping to a plan or lack confidence in your abilities to design a good plan, a course or program geared toward specific preparation for your test may help. However, enrolling in a course is no guarantee of success. It is your commitment and active preparation that will make the difference.

Remember, your plan is just that, YOUR plan. It may not look like the plan of someone who has a different background. It is your blueprint for taking control of your test-taking future.

Be Active in Your Preparation

To prepare for a test that measures your ability to think logically and demonstrate your understanding under a time limit, it is important that you be active in your preparation.

It is one level of understanding when you can grasp what you hear in a lecture or read or highlight in a book. But in order to own the material (meaning you can use the information in a new or novel context) you need to assert control and step it up to be active in your learning.

Here are some suggestions. Try them and make use of the ones that work well for you.

• Predict questions you would expect the test to ask, based on your understanding of material and format of test.
• Elaborate on the information and apply it to a new situation.
• Teach a peer to insure you have mastered the information and to identify "holes."
• Make concept maps or flow charts to show relationships.
• Use tables to make comparisons and contrasts.
• Try flash cards for reviewing details.
• Do the things that the test will ask you to do whether it is write an essay, read a graph or verbal passage, or make a calculation.
• Use catchy mnemonics or visual imagery to commit details to memory.

Yes, it is a lot of hard work. But learning can be fun, too. A good sense of humor can alleviate the weariness that comes with long, focused study. For an extra boost, visualize yourself in health professional school or practicing your profession.

Practice

Both untimed and timed practice, using the appropriate types of material, are essential in your preparation.

Untimed practice helps you to get ready for the test. Since you can focus on the reasoning and not the time limit, this practice can help you gain confidence in your abilities to answer the questions. You can also monitor your strategies for handling questions, identify areas that require more attention and change approaches that don't work. Here are some strategies to try.

• Restate the question in your own words to ensure you understand the question.
• Answer the question first without reading the options. This is helpful if you become distracted by the answer choices and miss the meaning/intent of the question.
• If you are taking a reading comprehension test there should be a passage with multiple-choice questions. Try answering the questions without reading the passage. This makes you focus on the question without interference from passage information. It is also a good exercise in reasoning through the choices.

Timed practice. Working under the restriction of a time limit adds another element of pressure to the test situation. To demonstrate the impact of a time constraint you could try these practice strategies:

• Work through a problem set under a time limit. Then, before checking your answers, repeat the problem set without a time limit. Compare the number of correct answers under each condition. If you correctly answered more items under the untimed condition then you may not need to review the material, rather, your task is to reason more efficiently under the additional pressure of a time limit.
• You may work up to desirable time limits gradually. Impose a generous time limit at the beginning and then gradually decrease it to conform to the constraints of the time you will be working with. Use a timer or a watch for your work initially. Learn when to guess and go on, it is never to your advantage to become stuck on a question.

Timed practice permits you to modify approaches that may have seemed effective during your untimed sessions but are too time-consuming.

Remember, what works for someone else may not be the best strategy for you. You want to be confident using YOUR techniques under test-like conditions so that there is no need to be concerned about changing approaches on the day of the test.

Analyze your Mistakes and Make Improvements

After you practice taking tests or sample items, you should identify areas where you did well and where you need to improve so that subsequent preparation is focused in areas where you need the most effort. Two people with the same score on a test may need to take different steps to improve their performances.

Take your time with this analysis and be brutally honest with yourself. No one else sees this information. You will be missing valuable learning opportunities if you simply score your questions and move on.

Try to understand the rationale for the correct answer to any item you miss while practicing. For each 'mistake' you make on a test, determine a probable cause.

• You should be able to explain why the correct answer is indeed correct and why the other options are incorrect. You may want to write your explanation in order to hold yourself accountable for being thorough. Sharing a verbal or written explanation with a partner gives you the opportunity to reflect on your thinking and receive feedback on the sufficiency of your explanation.
• You may find that you miss an item because of a problem associated with your knowing the information and/or a problem with test-taking skills. It is possible that a tally of the factors responsible for your errors will reveal a pattern and can help you confront problems associated with test-taking.

There are some general types of errors associated with knowing:

• I did not know details; my information was inaccurate or incomplete.
• I did not know a concept; my information was inaccurate or incomplete.
• I was not able to apply the information I knew.
• I did not know the vocabulary.

There are some general types of errors associated with taking the test:

• I did not understand what the question was asking.
• I answered a question different from the one that was asked.
• I made an easy question more difficult.
• I failed to consider key words such as except, not, least, most.
• I failed to recognize relationships in the material.
• I read part of the question and missed important information.
• I did not read all of the options carefully; I chose the first one that sounded right.
• I knew the answer but marked the answer sheet incorrectly.
• I changed the answer. My first response was correct.
• I did not finish in the time allotted and had to guess.
• I did not calculate correctly.

Remember, you have to make changes in your knowledge, skills or test-taking behaviors in order to improve your performance on the test. Your analyses of your mistakes on practice materials will help you make the needed modifications.

Be Test-Wise on Test Day

Taking a high-stakes standardized test is a physically, emotionally, and mentally exhausting experience. It is easy to recognize that stamina is a factor. It may seem like this is the test of a lifetime (at least to this point) so emotions play a part. Clearly you need to have the mental acuity to demonstrate your best performance.

The day before the test.

• Accept the fact that there is nothing more you need to review.
• Think positive thoughts. Visualize yourself being successful.
• Eat well. Exercise would be good. Fresh air is great.
• Plan some light entertainment for the evening.
• Make arrangements for someone to call you in the morning if you are worried about not waking on time.
• Have all your testing materials laid out so you are ready to go. You can take a snack for the break time with you to the test site so be sure you have purchased or prepared it ahead of time. Think energy boosting and restorative.
• Have a backup plan for unexpected problems with anything that could cause problems for you on test day, including transportation.

Test day.

• Dress in layers to be able to accommodate temperature variation in the room.
• Double-check that you have what you will need at the test site.
• If you are worried about having good concentration at the beginning of the test you might want to warm up by working some practice questions before you leave home. It is not necessary to score them, just work through them to wake up your brain.
• Leave home early enough to cope with transportation, parking, and finding the test site (if you have never been there). Find the restroom.
• Relax. Breathe deeply and slowly. Think positive thoughts. Avoid talking with overly anxious others.
• If the day does not proceed smoothly, you need to be resilient. Have faith in your preparation. Take another deep breath and continue. You can handle it.

As you equip yourself with the information and skills that you need, practice to become proficient, and plan for various contingencies, you will gain the confidence you need to meet the challenge of taking the test