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5 Reasons A USMLE Review Is Vital Despite High Academic Ranking
Can two or more tasks be performed simultaneously at the same level as if they were individually? How good are you at driving and typing on your cell phone at the same time? By the way, don’t try the above. It’s dangerous! Do you feel qualified to drive while typing because years of experience make shifting and pedaling second nature to you? If driving is second nature and texting is inherently easy, why do traffic accidents happen while texting?
Besides the most common Freudian slides, have you heard of action slides? Action sheets are performance actions that were not intended. Before these bursts of action occurred, your previous routine actions caused them. They didn’t come naturally to you earlier in life, but with repeated practice they become second nature. Here are the reasons for these errors:
- Memory storage failure. This includes redoing an action that has already been completed. For example, you would pour a second pot of boiling water into a pot of freshly brewed tea without realizing that you had already brewed the tea. Does this sound familiar? You can’t afford to fail like that on your USMLE, can you?
- Sequence failure. It involves forgetting the goal of a certain sequence of actions and moving on to another goal. An example might be intending to turn on the radio but instead walking past it and picking up the phone. Usually this happens in the morning, but instead of the morning ritual of turning on the radio or coffee and taking the newspaper, you mentally note that you have to call a colleague in the morning, and therefore in the order of failure.
- Subroutine failure. This involves either omitting or rearranging stages in the behavioral sequence. An example would be making a pot of tea but not putting any tea bags in it. This is normal when you are committing new information to memory, such as reviewing the USMLE for homework.
- Discrimination failure. It involves the inability to distinguish between two objects engaged in different actions. An example might be mistaking toothpaste for shaving cream. Funny? You shake your head, wash off the shaving cream and grab the toothpaste. But in doing so, you think about the facts you learned in the USMLE review sessions or the analysis you discussed with your colleague a few hours ago. Sometimes you call this situation “absence”.
- Failed to build the program. This includes an incorrect combination of actions. Examples include unwrapping candy, putting paper in your mouth, and throwing the candy in the trash.
It can be difficult to understand why these things happen, but there seems to be a slippage to action for actions that are highly rehearsed and overlearned. But if they are highly trained, then why are they prone to mistakes?
The reason is simple. The first time you perform an action such as an intramuscular injection or IV, you are fully aware that your performance is being evaluated by your instructor. As such, you make a conscious effort to remember the required steps. But when you’re on month-to-month wards, there are common lapses in action, like forgetting that you need at least two cotton swabs to do the job – one to clean the injection area and the other to apply to the area when you pull the needle out. This is just one of the many routine tasks you may often perform in a hospital as a medical student.
So you may feel that your medical classes have adequately prepared you for the USMLE exam. Similarly, you may feel that your high academic ranking is a sign that you do not need to study for the United States medical licensing exams outside of your routine classes. However, slips happen all the time as part of human nature. So it’s not just “below average” students who need to study vigorously for their licensing exams. All students, even those with the best academic records, will benefit from the USMLE’s rigorous and routine review.
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