Vision without action is a daydream.
Action without vision is a nightmare.

Japanese Proverb

Marathon way

Six months ago, I started a journey towards an important goal – running the Melbourne Half Marathon.   This will be my fifth (and probably last due to my rapidly expanding injury repertoire), and I am not new to running, but have found the training for this race more challenging than the others.  During my last training run this morning before ‘recovery week’, I was reflecting on the different ways I had prepared for this goal, and I discovered some important analogies with assessment preparation.

When I first took up long-distance running, I gathered information on how to prepare for a race from many different sources.    I integrated this into my own training plan, which I followed religiously, set realistic expectations for the race, and ultimately achieved a good result.   As I became more ‘experienced’ my dedication dropped off as I didn’t think I needed help – I’d been there and done that – but my results weren’t as good as expected.  I had been adamant that I could do it again on my own, as I had before.  Then I realised was two important things:

  • If you continue to prepare in the same way, you get the same result.
  • If you engage the assistance of someone else you will gain insight into areas that you can improve on.

So, this time, I have a running coach.

Over my time as a Medical Educator, I have seen three approaches to exam preparation:

  1. ‘I’ll just give it a crack’:     Often this is the approach of experienced doctors who will give the exam a try to see what it’s like, with the hope that they will pass.   This would be akin to entering for a long-distance run just because you are a regular jogger and can be a painful lesson learnt.
  2. I just need to read the basic resources and I’ll be right‘:   Sometime this approach is successful, if in addition to a sound knowledge base. But, how do you know what you don’t know and what is really needed to get across the line?
  3. I have a plan and some extra support’:   It is important that we choose the ‘training plan’ that suits us best and feel in control of our learning.   It is equally important to have some external guidance on our weaker areas, and to give us a point of reference as to the scope of learning.   Your extra support may be a study partner, colleague in your practice, Medical Educator or external course – it’s whatever works for you.

The difference between passing and failing is having a structured plan, covering the content required, over a reasonable time.   So how do you know what content is required?   It’s called a curriculum.    As an educator, I am constantly astounded at how many doctors haven’t looked at the curriculum to develop a study plan.   Its purpose is to guide your learning.

To prepare your study plan, look at the RACGP curriculum and decide for each contextual area if you are confident with its content or not.   If not, target those areas first.   You should also familiarise yourself with the Bettering the Evaluation and Care of Health (BEACH) data which outlines the common presentations in General Practice.   These topics contribute to about half of the exam content (over the AKT, KFP and OSCE).

Once you have your plan, you need some benchmarks so that you can continually assess how you are going against your plan, and more importantly, if your knowledge is of an adequate standard.    This is akin to using an App or device to check your pace in running.  One way of bench-marking your study progress is to self-test with questions.  This technique is fair, but to be valid and reliable, requires an extensive bank of well-written and contextually correct questions (just like in the exam!)   A complementary way to ensure that you’re on the right track is to engage with a coach, program, colleague, or study partner who can highlight for you when you’re going to slow or are missing something in your training schedule.

An often-overlooked component of achieving a goal, is forgetting the bigger picture.   We can get so caught up in the process of getting there, that we forget why we are doing it in the first place.   Yes, it is important to pass the exam, but what is more important is that you will be a better doctor as a result of the process.  This requires study and dedication, but it also requires self-care and time for recovery as part of your training.

So, every once in a while, take a break from the relentless immersion that is training hard, and visualise that moment when you will feel competent and confident in your medical practice, and you’ll soon be running down Marathon Way with a spring in your step!

 

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