Clinical Vignettes: Powering Firecracker Exams

Posted by Trevor Rosenlof on Nov 23, 2015 9:27:44 PM

If you're not yet a Firecracker member you can sign up for free - instant access to over 2000 clinical vignettes to help you practice and prepare for USMLE Step 1. 


The team here at Firecracker is super excited to announce the introduction practice exams as part of our core product!  And as part of this introduction, I’d like to explain a bit about our clinical vignettes (CVs), including the history of our CVs, how many we have, where they came from, who writes and edits them, what makes a good CV, how to integrate them into your studies, and much more.  There is an insane amount that can be said about CVs, way more than can be written in a single post.  So this is the first of many to come.

Where do Firecracker’s clinical vignettes come from, and how is high quality assured?

We have a team of medical students, residents, and attendings who author and review every CV.  We begin by only hiring the best authors and editors.  Our content team is comprised of individuals who are consistently at the top of their class and perform well on standardized exams.  The average Step 1 score of our content team is 254!  We feel it is critical to have a team of editors at various points in their training.  Some of our editors are medical students, some are residents or attendings.  This is because a student will have insights into what makes a good question that an attending might not have and vice versa.  All of our questions are reviewed by multiple people to assure they meet the highest standards.

So what makes a high quality clinical vignette?

Obviously a question needs to be factually correct.  A quality question needs to have a thorough explanation.

But the question of what makes a CV high quality is is actually a pretty complex.  A lot of this depends on the context and use of a CV.  Is a CV going to be used as part of timed practice exam?  Is it used as a diagnostic indicator of what a student knows or doesn’t know?  Is it primarily being used as a learning tool?

We plan on posting subsequent blogs posts that detail what makes a quality CV.  We will dissect CVs to illustrate the difference between good and bad quality.  This will also help you understand what goes into a CV so that you can approach the test from the perspective of the test writers.  More to come!

How does Firecracker you assure continual quality of these vignettes once they are authored?

We regularly audit our questions and weed out those that aren’t good enough.  This is critical to make sure our content stays consistent with current practices and information in medicine.  We also greatly value feedback from our users.  If you ever find something you don’t like, whether it’s a simple typo or you feel a major error, let us know!  We’ll listen and address it.  And if you find something you like, let us know!  We’ll provide more of the types of questions that you find helpful.

So an individual clinical vignette might be good, but what about the sum of all vignettes?

A question bank might have amazing questions, but if it doesn’t cover all that a student needs to know, then it’s not good enough.

Whenever we make a practice exam, we look at the exam outline and follow that.  When making a practice shelf exam, we look at the NBME guidelines and follow them.  Our exams have the same amount of emphasis on various subjects as the NBME exams.

So how can you use these questions?

We have used our questions to create pre-built exams, which will be available beginning November 24, 2015:

  • Step 1 diagnostic exam:  We have a 4-block Step 1 diagnostic exam.  Most students take this towards the start of their dedicated Step 1 studying to serve as a benchmark and indicate what they need to work on.
  • Anatomy/Embryology practice shelf:  For first year students getting ready for their anatomy/embryology final or shelf exam, this is for you!  We have two versions, one that is anatomy only and one that includes embryology.
  • Internal medicine practice shelf:  Internal medicine is the foundation of all specialties, and this exam will help you learn the high yield material and get ready to crush the shelf.
  • Pediatrics practice shelf:  Pediatrics is a common clerkship and this exam will ensure that you’re prepared for the full shelf when the time comes.

And much more!  We are releasing practice shelf exams for all of the core clerkships and basic sciences.  We are putting together full-length Step 1 and Step 2 practice exams.  And of course you can just get on and build your own exams to focus on what you need on any given day!

Be on the lookout for more blog posts to come where we will go in depth about the various aspects of our question bank.

Happy ‘Crackin!!

Trevor Rosenlof is Firecracker’s Director of Content. He’s also a graduate of Tulane Medical School, now in his Transitional Year residency in Knoxville, followed by ophthalmology in Columbia, Missouri.

Topics: USMLE, Practice Exams, Exams

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