How to Read Vignettes- Efficiently!

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yield sign to stop and read vignettes efficiently

One of the sections of exams students have the most difficult time with is the vignettes section. We’ve discussed this topic before here, where we show how to break down the process of answering vignettes. But in this blog, we’ll get into the nuts and bolts of reading the passages a little more effectively.

Formatting is everything

First, how you approach vignettes will depend on what format they are in. A video vignette requires you to sit through a segment of recorded interactions and glean information off of those interactions (usually between and doctor and patient). A written vignette gives you a block of information you can refer back to to answer questions.

The key difference between these two is time management. For a video vignette, you won’t want to waste your exam time going back and re-watching the video (which isn’t allowed in some cases, anyway). You can’t control the speed that the video plays, so you’re at the mercy of the media to go through its time. Because of this, you’ll want to pay close attention as you watch through the video the first time. Thankfully, bits of video can stick out as they’re composed of dialogue instead of raw facts, and this can help recall later.

Video Vignettes

As you watch the videos, keep in mind what should stick out- deviances from typical life, distress from a symptom, dysfunction due to ongoing issues, or potential danger to the self or others. This is a simple concept, but it’s usually the part that you need to pay attention to. An important factor in video vignettes to pay attention to is HOW to patient says these things. You’ll likely be quizzed on not only the information presented, but also how that information is delivered. Is the patient frenzied, calm, mood incongruent, or lethargic? Is that relevant to what they’re saying? It’s a lot to keep track of, but when you have to spend your time wisely, it’s best to dial into those videos.

Written Vignettes

Conversely, written vignettes will take up your time in a different way. Typically you’re presented with a fleshed out story and asked to determine answers that are either insinuated or determinable based on that information. For these, you can go back and re-read sections as you go. This means you don’t have to be laser-focused the first time reading it, and you can refer back to it. But this also means the questions involved may be a bit trickier and require more introspection. Keep in mind the basic information presented (i.e., demographics, time range of symptoms, key issues going back to the 4 D’s). Then as you delve deeper into the questions, refer back for more specifics.

Take away-

Vignettes are challenging. And they should be, as they are the more accurate representation of what it’s like working with real-life patients. And just like patients, they have their individual quirks that make them unique each time. A great way to get comfortable with these questions is the PRACTICE! Take time to go through and get used to what kind of information you need to pay attention to, in a setting that doesn’t penalize you for time.

We tailor each bank to the type of test you’re taking, whether that is Nurse Practitioner Mental Health Certification, ABPN, USMLE, or PRITE. You can take these practice exams over and over again until you get the hang of it. You can use the timed mode that mimics the actual exam so you really get in the groove of managing your time. Give our clinical vignettes a try- totally FREE – using our Free Trial!

If you like what you see on the trial, check out our Question Banks and find the best option for you! Or, contact us with any questions you have so we can get you on the right path today!

Controversial opinions: medication vs. talk therapy

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pharmacal therapy vs. psychotherapy

In the world of psychiatry, it’s common to come across differing opinions on the best way to manage various disorders. Some clinicians prefer combination therapy, some support pure psychotherapy, while others trial pharmaceuticals prior to engaging in talk therapy. With multiple avenues available, what’s the best approach?

We took a look at a review of 102 meta-analyses of how professionals across the country handle different categories of disorders and their resulting efficacy. And guess what?

There’s no one size fits all! That’s right. This review that looked through 3,782 RCTs and 650,514 patients (all adult) found small benefits for both pharamcotherapies and psychotherapies (SMD=0.35). In their break down, the authors show that clinicians across the field generally favor a combination of both interventions to address conditions such as depression, social anxiety, OCD, and PTSD when compared to monotherapy. However, there are still notable benefits for each condition when using monotherapy! So…what’s the take away?

When considering treatment options for your patient, you need to consider their individual case. Some patients are fine with monotherapy, whether that is psycho or pharma, and some require a little of both. It’s your job as the professional in the field to assess which way is best for them. And so long as you do your due diligence, the data suggests one way over the other isn’t necessarily “better” (so, so there therapeutic purists!)

Making judgement calls can be tricky. A great way to get more comfortable is to practice! Learn more about treatment options and give your assessment skills a work out by going through our Diagnostic Procedures and Psychopharmacology topics. Give our question banks a try- FREE- using our Free Trial! Or if you’re ready to take the plunge, check out our Question Banks and find the perfect fit for you! Or, contact us with any questions you have so we can help you prep in the best way for you

REFERENCE:

Leichsenring, F., Steinert, C., Rabung, S., & Ioannidis, J. P. (2022). The efficacy of psychotherapies and pharmacotherapies for mental disorders in adults: an umbrella review and meta‐analytic evaluation of recent meta‐analyses. World Psychiatry, 21(1), 133-145.

What’s the Tea on the USMLE?

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The United States Medical Licensing Exam is a year-round board examination for anyone wanting to practice medicine in the U.S. This includes psychiatrists and psychiatric candidates who can sit for the USMLE Step 2, Clinical Knowledge. So what do you need to know about it?

Registration Timeframe

The USMLE can be taken at (almost) any time throughout the year. The candidate submits a 3 month period in which they can be available to sit for the exam, excluding the first week of January or specific major holidays. After the examination is complete, results can be expected anywhere from 2 to 4 weeks later.

Cost

Step 2, CK now costs $1,000 to register and take the exam. This price increased from $965 as of January 2023. Step 1 and Step 2 are both this cost.

Exam Breakdown

The USMLE Step 2 consists of about 318 multiple choice questions administered over eight 60 minute blocks. This means you have about 90 seconds per question. You also get 45 minutes total of break time. If you finish a block early, the remaining time is added to your break time.

Exam Material

Exams for Step 2 include System Specifications, Physician Competencies, and Discipline Competency. Breakdowns for each of these are found below (these can also be found at the USMLE website here)

USMLE systems
USMLE physician competency
USMLE discipline competency
2023 Information Bulletin

The full scope of information for the USMLE 2023 can be found in this bulletin taken directly from the USMLE website.

Getting ready to take the USMLE, or just starting to plan it out? We can help you! Check out our USMLE Question Bank tailored specifically toward getting you ready for the Step 2, CK Psychiatry and Neurology sections!

How Many Ways Are There to Prep for Tests?

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test prep like a tortoise

Everyone has their own unique style when it comes to getting information into their noggin’. Test prep can take many shapes and forms, and what works for one person might not work for another.

Prepping for a board exam can be incredibly stressful. The weight of your career decisions rests on the outcome! (No pressure, right?) To cope with this stress, test prepping can manifest as several different approaches: the WINGER, the PROCRASTINATOR (aka, CRAMMER), and the TORTOISE.

The Winger

The Winger is the person that lets go of the immediate stress the exam is putting on them, and puts it out of their mind. They know it’s coming up, but they have confidence in the amount of information they have stored in their brains. The have an uncanny ability to refresh the knowledge and consolidate retrieval just by existing….or so they think. These test takers waltz into their exams and take a gamble that they will have all the answers (or at least enough to pass!). Depending on the type of test you’re going to take, being a Winger can work OK. Think 100 level undergrad classes. ABPN, PRITE, NP, or USMLE? This might not be the best approach.

The Procrastinator

The Procrastinator (aka, Crammer) is similar to the Winger. They also put off prepping for as long as possible. But while the Winger tends to follow through on their approach, the Procrastinator usually gets MORE stressed by avoiding it, and ends up cramming as much studying in as possible in the last day or so leading up to the exam. Cramming can be beneficial when compared to not prepping at all, and for some individuals, cramming is their sole means of test prep. Can it work? Probably. Is it great for your mental health? Not really.

The Tortoise

Lastly, we have the Tortoise. This name harkens back to Aesop’s Fables, as it should, because this test prepper takes the slow and steady approach. Plunking along, little by little every day, this prepper integrates new bits of information into their mental arsenal. They challenge the knowledge they already have to increase retrieval. The process starts closer to a few months ahead of time, as opposed to overwhelming themselves with whole textbooks 48 hours before their next exam. Instead, they have time to relax and take in some self-care in the days leading up to the exam so that they are refreshed and ready to go.

Is any one of these approaches superior? Research would suggest there is favorable option- we’ll let you decide which one you think it is 😉 In the meantime, if you’ve been relying on being a Winger or a Crammer up to this point, let this blog be your sign to give the Turtle Club (yes, that’s an early 2000’s movie reference) a chance. Give our question banks a try- FREE- using our Free Trial! Or if you’re ready to take the plunge, check out our Question Banks and find the perfect fit for you! Or, contact us with any questions you have so we can help you prep in the best way for you.