Why a one-size fits all exam approach doesn’t work.

Home » Why a one-size fits all exam approach doesn’t work.

In a few months you have an important career-related event. It may be the first time you’re attending, or you may have been there many times before, and if so, you want to stand out this time and own your turf.  Last time you went along, it didn’t quite turn out as you planned.  So this time, are you going to prepare and dress the same? And if so, would you expect a different outcome?

The same approach gains the same results (and how embarrassing it would be to turn up in the same outfit as someone else and not be noticed at all!).

 We all learn differently and apply those learnings in the context of our medical practice – which are not uniform. So how can a prescriptive weekly course of study and resources assure a uniform result? It can’t – otherwise everyone would pass just by completing a particular course. A course of study should embrace the individuality of its learners.

Successfully passing GP Exams is about contextualisation of your knowledge – and you can’t learn that from a book.

So how do we define what individual factors influence our learning?

Consider:

  • How you like to learn: Try a Learning Styles Questionnaire.
  • How you like to teach
  • How you were taught, I.e. didactic versus problem-solving based learning
  • What type of practice you work in, e.g. urban vs rural
  • What demographic of patients you see?
  • The impact of experience and biases on your clinical reasoning.

If you take the time think about the above, then the next step is to consider how you might ‘mix up’ your study preparation. If you keep taking the same approach then you will achieve the same outcome.

One really useful approach to study is to use Random Case Analysis (RCA).  This technique was introduced by Dr Simon Morgan and Dr Gerard Ingham, both experienced Medical Educators.   You can read more about the technique here.  Random case analysis encourages you to think about a case from different perspectives:

  • the patient, the doctor, the problem, the system;
  • the domains of practice.

It is particularly good for helping you to discover the areas that you don’t know that you don’t knowHere’s a useful template explaining how you can use RCA to increase the depth of your learning and make study more interesting.

“But my approach has always worked” – yes, but perhaps that was in a different education system, at a different stage of training or for a different type of assessment.

If a one size fits all model worked in GP Education then we wouldn’t need plans for learning, educators, mentors or supervision. Competence in General Practice requires reflective practice and lifelong learning. Just like we should never treat the patient entirely on their investigation results, or treat their disease rather than their dis-ease, we shouldn’t expect prescriptive and uniform formulas for exam success. And when dressing for a big event, avoid the generic outfit that covers up your less favourable aspects, acknowledge the parts that can be enhanced and engage a quality seamstress or tailor to make the most of your attributes!

Please feel free to comment.

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