General Studying Techniques
for Board Exams

Preparing for board exams requires holistic preparation, encompassing not only academic readiness but also a comprehensive approach. According to Macmillan Dictionary (2023), board exams refer to "a set of tests you take to be allowed to work in a particular area as a doctor, nurse, etc." These examinations vary in question types and the depth and breadth of content knowledge required. The objective of these exams is to assess students’ knowledge and skills in information comprehension, decision-making, and answering questions to gain admission to a university or college, obtain a board certificate to validate professional expertise, or, in your case, qualify for nursing work in the United States.

In this topic, you will discover recommended study techniques to excel in board exams in general, including specific recommendations for nursing and medical board exams. These suggestions provide a starting point for your preparation, but it is crucial to develop your own study method for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam, as technique might vary depending on individual students. We trust that you find this topic valuable in your pursuit of passing the board exam and pursuing a career as a nurse practitioner in the United States.

1.1 The Study Cycle

Each student is different, but nearly every educational framework follows a series of steps to ensure that the learner discovers, generates, and transforms data into information that can be applied on everyday life or specific situations. When studying, there are activities that everyone can engage in to enhance and streamline the way they access the necessary information.

The Louisiana State University Center for Academic Success (2021) proposed “The Study Cycle” which is based on the PRLS system developed by Frank Christ. This cycle consists of five steps, as depicted in the diagram below:

Figure 1

The Study Cycle

Adapted from Louisiana State University Center for Academic Success. (2021). The Study Cycle.
https://lsu.edu/cas/earnbettergrades/tipsandtools/files/2021studycycle.pdf

These five steps could be applied to this NCLEX preparation program:

• Preview > Before starting the study of any topic in this program, it is crucial to review the course material to identify the concepts, key terms, and general ideas that need to be covered for the credential. This process will help you pinpoint areas where further exploration is needed to excel in the NCLEX exam.


• Attend > In this program, instead of attending classes, you will have access to online information and resources that will help you gain deeper insights into specific topics relevant to the NCLEX exam or the nursing profession in the United States. Direct your attention to the concepts you identified in the previous step. Tip: Keep an English-Spanish medical or nursing dictionary nearby to review technical terms that you are unfamiliar with or require additional contextual understanding.


• Review > When you complete the review of the course material for each topic, it is essential to allocate time to summarize the key concepts and identify any gaps or questions that require further exploration using additional resources. Moreover, being able to explain the concepts to yourself is of utmost importance.


• Study > This is a critical step within the study cycle, as it entails concentrating on studying the materials, your notes, and the available resources. The Louisiana State University Center for Academic Success (2021) outlines five steps that you can employ during your study sessions:
• Plan: Set a specific goal for your study session, taking 1-2 minutes to do so.
• Study: Dedicate 30 to 50 minutes to implement studying strategies such as utilizing concept maps, reading for comprehension, analyzing case studies, and more.
• Break: Allocate 5-10 minutes to step away and refresh your mind.
• Recap: Utilize 5 minutes to summarize the content you have studied and conclude the session.
• Decide: Assess whether to continue studying, take a longer break, or switch materials or subjects.


• Check: Following the study session, assess the effectiveness of your study methods and strategies considering if any adjustments are necessary. Additionally, evaluate your ability to teach the material to someone else, as this will aid in determining whether further study on the same topic is needed or if you can proceed to the next one. Upon program completion, practice resources with questions will be available to you. We highly recommend engaging in ample practice to familiarize yourself with the question types and logic of the NCLEX exam.

Check the videos of the LSU Center for Academic Success about The Study Cycle.

1.2 Studying Techniques & Skills

As a nursing student, you might have discovered practical methods to enhance your learning experience. Currently, you might be managing the demands of a full or part-time job, along with various responsibilities inside and outside your workplace. This is a common reality for many individuals in the healthcare profession. Furthermore, in the United States, passing the NCLEX exam is essential for gaining opportunities as a Registered Nurse in healthcare institutions.

To excel in the NCLEX exam, or any other board exam, it is essential for you to identify studying techniques that align with your unique circumstances. In this section, you will discover information about various techniques. However, it is vital to remember that this journey is personal to you. You must adopt study techniques that best suit your schedule and preferences.

Studying is more than just reading.

The traditional approach to studying for an exam typically involves repetitive reading of notes and class materials to memorize concepts and essential ideas. However, a board exam demands more than mere memorization; it necessitates critical thinking and comprehensive understanding of the concepts presented in each question or case. Since 2023, the NCLEX exam has incorporated more context-based within clinical cases, making memorization only a part of the process. That is why active engagement is a recommended study strategy.

The Learning Center at the University of North Carolina, Chapel Hill, defines active engagement based on the work of Davis as "the process of constructing meaning from text that involves making connections to lectures, forming examples, and regulating your own learning" (Davis, 2007, cited in The Learning Center, n.d.). To develop this study technique, they provide several suggestions, including:

• Generating study guides organized by topic.
• Creating questions, problems, or cases with corresponding answers, even creating your own exam questions.
• Assuming the role of an instructor by explaining concepts in your own words.
• Relating the cases and questions to your personal experiences.
• Constructing concept maps or diagrams.
• Employing symbols to represent concepts.
• Approaching studying in terms of question, evidence, and conclusion. What is asked by the instructor or author? What evidence is available? What is the conclusion?

Newport (2007, cited in The Learning Center, n.d.) recommends organizing your materials before embarking on active review of the exam topics. In this course, it is recommended to review all the suggested material listed in the resources section and bibliography for each topic. Additionally, there are plentiful free online resources accessible for the NCLEX exam that can assist you in studying actively and reaching your main goal.

The SQ4R method

According to the University of Guelph (2023), the SQ4R method is an active learning strategy that can be customized to suit various study preferences. SQ4R stands for Survey, Question, Read, Respond, Record, and Review. This method offers structure and aids learners in retaining the most important information within each studied topic, despite the initial perception of it being time-consuming.

There are multiple advantages to employing the SQ4R method. First, as you read, you will be generating study materials, thereby increasing your involvement with the content. Secondly, it enables you to identify areas that might require further study, helping in the resolution of any knowledge gap. Lastly, utilizing this method can save time in the long run since you will be concentrating on the most pertinent information.

The six steps of the SQ4R method are as follows:

Table 1

The SQ4R Method

NCLEX® Questions Analysis as Study Technique.

As you advance in the course, you will discover that the NCLEX exam comprises distinct question types. Grasping the mechanics of these questions and mastering the art of analysis are valuable study techniques for this exam. It is crucial not only to practice answering simulated NCLEX exam questions but also to analyze to extract maximum value from the experience.

The Joyce University of Nursing and Health Sciences (2022) has outlined eight steps to assist you in analyzing NCLEX questions and optimizing your comprehension of each question:

1. Read the entire question: It is crucial to read the entire question before examining the answer choices. Many incorrect answers arise from a failure to fully understand the question. Allocate sufficient time to ensure comprehension of what is being asked.


2. Ask yourself first: Take a moment to rephrase the question in your own words. This step helps in verifying your comprehension of the question and guarantees that you are addressing the accurate problem or scenario.


3. Consider the question type: Familiarize yourself with the various question types encountered in the NCLEX exam. In the upcoming topic, you will gain further insight into these question types. Determine whether the question falls under the category of a priority question, where you must identify the action requiring immediate attention or the highest priority. Alternatively, it might be a positive or negative question, necessitating identification of either the correct answer or the incorrect option.


4. Focus on each answer option: Once you have comprehended the question, proceed to read all the answer options and deliberate on each one carefully.


5. Determine if the answers are wrong, right, or possible: As you review the answer options, identify any choices that are evidently incorrect and eliminate them from consideration. Remember that in negative questions, you need to identify the false answer. Understanding the question type is essential to approach the answers appropriately.


6. Rank your correct and possible options: After evaluating the answer options, prioritize those that you believe are correct or have the potential to be correct.


7. Reread the questions after choosing “finalists”: Once you have narrowed down your options, reread the question while keeping your best choices in mind. Evaluate which option aligns better with what has been asked.


8. Decide and move forward: Select the option that you consider correct. Once you have made your choice, resist the temptation to second-guess yourself and proceed to the next question. Remember to manage your time effectively as there is a time limit for the exam.

Remember that these strategies are just a few examples of the many options available to you for preparing for the NCLEX exam. It is important to explore and find additional resources that align with your preferred study process. Every individual has unique learning styles and preferences, so feel free to explore different techniques and materials that best suit your needs. The more diverse resources you gather, the better equipped you will be to excel on the exam.

1.3 General Strategies

Now it is time to introduce some general strategies for studying that can help you excel in the NCLEX exam. As you search for study tips and strategies, you will find that many resources focus on some of the following subjects:

1. Time management
• Effective time management plays a pivotal role in achieving success while preparing for the NCLEX exam. This is especially important for international nurses who face limited opportunities to take the exam and must strictly adhere to specific application dates and deadlines.
• During the exam, you will have a designated amount of time to answer all the questions. Thus, it becomes absolutely essential to manage your time wisely and respond with utmost efficiency.
• When studying for the exam, possessing good time management skills is also essential. Consider the following tips:
• Create a schedule or calendar that includes important dates, deadlines, and dedicated study time.
• Utilize time management apps or tools to help you organize your study and break periods effectively.


2. Learning environment
• The University of Saint Augustine for Health Sciences (2020) provides five recommendations to create an optimal study environment:
• Switch up your environment: Rather than confining yourself to a single study, consider exploring different places like coffee shops or libraries. A change in environment can improve your memory and concentration. Just ensure that the chosen place is not excessively loud or crowded.
• Prioritize sleep: As a health professional, getting sufficient sleep might be challenging, but strive to accumulate several nights of quality sleep before intense study sessions. Adequate rest is essential for optimal cognitive function. Also, make sure to get a good night's sleep before the exam to perform at your best.
• Listen to calming music: Enhance your study sessions by listening to calming music, such as lo-fi beats, classical melodies, or instrumental tracks. Research suggests that these types of music can boost attention and focus. However, avoid music with lyrics, as it might be distracting.
• Eliminate distractions: When studying, power down your cellphone, disable email notifications, and stay away from social media platforms. Make a commitment to fully immerse yourself in your course lectures or study materials during your study sessions. Minimizing distractions will help you maintain focus and increase productivity.
• Snack on smart food: Instead of relying on coffee or sugary snacks for a quick energy boost, opt for "smart and healthy" snacks. Nourishing choices like apples, bananas, and berries, nuts and dark chocolate provide sustained energy and improve cognitive function during long study sessions.


3. Prioritizing topics
• UTEP Connect (2021) suggests six techniques to prioritize effectively:
• Create a To-Do list: Begin by writing down all your topics and assignments, clearing your mind and having a visual representation of what needs to be done and studied. This practice helps in organizing your tasks and keep your focus intact.
• Manage your expectations: Embrace a realistic outlook regarding what you can achieve within a given period. Avoid overwhelming yourself by attempting to study all the material at once. Instead, prioritize the most critical areas and focus on those first to progress towards your goal of passing the NCLEX exam.
• Use the MIT (Most Important Tasks) Methodology: Instead of trying to tackle everything at once, identify three tasks or topics that hold the utmost important for the day. Begin with these tasks and then move on to the next three. This approach fosters enhanced focus and productivity.
• Eliminate distractions: Power down your phone, television, or any other electronic devices that could distract you during your study sessions. By minimizing distractions, you can concentrate better and make the most of your study time.
• Focus on your High-Value Activities (HVAs): HVAs encompass the activities that directly contribute to your goals. In the context of the NCLEX exam, prioritize tasks that are integral to your exam preparation and help you achieve the goal of passing. Allocate your time and effort wisely to these crucial activities.
• Be flexible: unexpected events or circumstances might arise. Maintain adaptability and awareness that you might need to adjust your list of activities or reschedule study sessions. However, ensure that any changes you make are feasible and aligned with your overall goals (remember to manage your expectations).


4. Study group
• Studying in a group can be a highly beneficial technique to elevate your preparation for the NCLEX exam. Here are some key points to consider when forming and participating in a study group:
• Joining a study group offers numerous advantages, including maintaining focus on your materials, receiving assistance in answering questions, having the opportunity to teach and reinforce your understanding, gaining motivation when needed, and gaining different perspectives on topics.
• To ensure the study group utmost effectiveness, it is imperative to maintain a small group size. Select committed colleagues who demonstrate unwavering dedication to their studying and are willing to actively contribute to the sessions.
• The Learning Center (n.d.) suggests the following guidelines for a study group:
• Meet regularly, preferably once a week.
• Choose a suitable online platform if members are in different geographic locations.
• Establish ground rules for the study sessions to ensure everyone's participation and cooperation.
• Designate a facilitator to keep the sessions organized and on track.
• Ensure that all group members come prepared for the sessions.
• Set a study agenda to cover specific topics or areas of focus during each session.
• Encourage group members to bring and create questions for discussion and problem-solving.
• Utilize active learning strategies, such as group discussions, concept explanations, and collaborative activities.
• Keep a record of the group's progress and outcomes, and plan for the next session accordingly.


5. Avoid multitasking
• Multitasking can prove detrimental to effective studying. To maximize your study sessions and retain information efficiently, it is crucial to maintain focus and avoid distractions. Here are some strategies to help you stay on track (Brubaker, 2022.):
• Establish a schedule.
• Take planned breaks.
• Avoid digital distractions.
• Organize your study environment.
• Use focus techniques.
• Practice relaxation techniques.
6. Use resources
• To support your NCLEX exam preparation effectively, it is crucial to gather a variety of learning resources. Here are some open resources that can be helpful:
• Next Generation NCLEX Prepare to Success by the NCSBN (https://www.nclex.com/prepare.page)
• NCLEX prep Blog by Joyce University of Nursing & Health Sciences (https://www.joyce.edu/blog/tag/nclex-prep/)
• Free NCLEX® events & resources by KAPLAN (https://www.kaptest.com/study/nclex/)
• Next Gen NCLEX® (NGN): Free Nursing Educator Resources by KAPLAN (https://www.kaptest.com/blogs/nursing-educators/post/next-gen-nclex-free-resources-ngn)
• NextGen NCLEX Test Bank by Maryland Nursing Workforce Center at University of Maryland School of Nursing (https://www.nursing.umaryland.edu/mnwc/mnwc-initiatives/nextgen-nclex/nextgen-nclex-test-bank/)
• The Ultimate Guide to Next Generation NCLEX® by Nursing.com (https://nursing.com/next-generation-nclex)
• NCLEX-RN Unit: NCLEX-RN practice questions by Khan Academy (https://www.khanacademy.org/test-prep/nclex-rn/nclex-practice-questions)
• The examples provided are just a starting point, and there are indeed numerous online resources available to support your NCLEX preparation. The internet is a vast repository of information, allowing you to explore various websites, forums, blogs, and online communities dedicated to nursing education and NCLEX exam preparation.
• Here are a few more categories of online resources you can explore: Nursing Forums and Communities, Mobile Apps, Social Media groups and pages, Online study guides and cheat sheets, Nursing videos in online platforms.

1.4 Main Mistakes when Studying for Board Exams

As evident from the previous sections, studying for an exam entails more than simply reading or memorizing information. It demands a conscious process to genuinely acquire knowledge and be able to apply it in practical situations. The primary goal of this section is not to dictate what you should do but rather to emphasize common mistakes that many students make when preparing for board exams, including the NCLEX exam.

According to Akresh-Gonzales and Simmons (2022 ) from the New England Journal of Medicine Group Education, students often fall into the following nine mistakes when studying for board exams:

1. Thinking that you could learn things very fast
   Some students mistakenly believe that their success in college or previous academic endeavors equips them to swiftly grasp new concepts or solely rely solely on their existing knowledge. Consequently, they might not allocate sufficient time for thorough preparation or carefully plan their study schedule. However, the truth is that effective studying demands deliberate planning and dedication. Without a well-structured study plan and dedicated study time, there is a risk of either not studying at all or not studying effectively.
   
   Tip: Take time to create a study schedule and adhere to it diligently.


2. Believing that been a good student is innate and not the result of hard work
   Some students mistakenly believe that being a good student is an inherent trait reserved for certain individuals, leading them to underestimate the significance of hard work and effort in achieving academic success.
   
   Tip: Cultivate a Growth Mindset and acknowledge that intelligence and knowledge can be developed and enhanced over time with dedication and perseverance.


3. Believing that knowledge is composed of isolated facts
   Merely memorizing information without understanding its context or relevance can result to shallow learning and difficulties in retaining knowledge over the long term. However, actively seeking connections between different topics or concepts can lead to a more meaningful and interconnected understanding of the subject matter.
   
   Tip: As you study, be vigilant in identifying patterns, relationships, and similarities between various topics to foster a deeper and more comprehensive grasp of the material.


4. Not testing your weaknesses
   Students often tend to focus primarily on their strengths when studying, inadvertently neglecting the areas in which they might feel less confident or possess limited knowledge. However, it is crucial to deliberately dedicate time to test and prepare with materials that might be challenging or entirely unfamiliar. When preparing for your exam, it is essential to identify your weaknesses and prioritize studying those areas. During the actual examination, time constraints can exacerbate stress and frustration, particularly if students encounter questions or scenarios for which they are not sufficiently prepared.
   
   Tip: Make sure you understand all the subjects covered in the exam thoroughly. Identify your strengths and weaknesses, allocate study time and prioritize your weaknesses first.


5. Rely on passive study strategies
   It is common for students to rely on passive studying techniques, like reading and memorizing information which might not be the most effective way to study. However, incorporating active study strategies, as described in Section 1.2 of this module, can significantly enhance your learning and retention of information.
   
   Tip: Integrate active study techniques into your routine, such as summarizing key concepts in your own words, creating visual aids like concept maps or diagrams, practicing with sample questions, and teaching the material to someone else. By actively engaging with the content, you will deepen your understanding and improve your ability to recall information during the exam.


6. Not testing yourself on the exam material
   Roediger and Karpicke (2006), cited by Akresh-Gonzales and Simmons (2022), emphasize the effectiveness of the "testing effect" when studying for exams. Testing yourself on the material has proven to have a substantial and enduring impact on retention and recall.
   
   Tip: In this course, you will have access to a simulation exam, but it is highly recommended to make use of as many exam simulations as possible. Taking advantage of additional practice exams and available resources will reinforce your learning and enhance your performance on the actual exam.


7. Thinking that you could multitask when studying
   Multitasking might appear to be a means of accomplish more in a shorter period, but it actually hinders your ability to comprehend and retain information effectively. When you attempt to divide your attention between multiple tasks or distractions, your focus becomes fragmented, ultimately leading to reduced concentration and comprehension.
   
   Tip: To optimize your studying, steer clear of multitasking and instead dedicated, uninterrupted time to your study sessions. This focused approach will enhance your learning and yield more fruitful results.


8. Relying solely in the information of instructors to be prepare
   Some students believe that studying only the materials provided by their professors is sufficient for excelling in exams. However, it is crucial to recognize that wealth of information and resources exists both online and in physical form, which can significantly enhance your understanding and preparation.
   
   Tip: Always seek out available resources that can assist you in preparing for the exam, tailoring your approach to align with your individual study style. Expanding your sources of knowledge will undoubtedly elevate your academic performance.


9. Studying without an order
   When preparing for a board exam, approaching the content with a clear strategy in mind is crucial. Remember to consult the exam guides or plans provided on the board's website or social media platforms. For instance, the NCSBN's website offers numerous resources to help you understand the exam structure and the percentage distribution of topics to be covered.
   
   Tip: In the upcoming section, you will find more detailed information about the NCLEX exam. However, it is also beneficial to explore other websites or YouTube for supplementary information that can complement your understanding and preparation.

It is crucial to identify these common mistakes and take proactive measures to avoid them. Creating a well-structured study plan and committing to following it is important in preparing for the NCLEX exam, which ranks among the most critical board exams in the United States. While this program offers valuable information and resources, it is equally essential to explore additional materials that align with your unique learning style and preferences.

There is an abundance of information available both online and offline that can complement your study efforts. Make the most of credible sources, exam guides, practice questions, textbooks, and other study materials that best suit your needs and preferences. Finding the right resources that resonate with you will significantly enhance your understanding and preparation for the exam. Remember, the key is to create a study plan that works for you and to utilize resources that align with your learning style and goals.

a board exam can feel intimidating, but it all depends on your approach and level of preparedness. Understanding the study cycle can help you create an effective study plan and provide a structured path to follow. Additionally, discovering study techniques and skills that work best for you will enable you to study more efficiently and make the most of your study time. By incorporating general study strategies, such as organizing your study space, utilizing relevant materials, and creating a conducive learning environment, you can enhance your chances of success on the exam. Lastly, being aware of common mistakes that students make when studying allows you to develop a plan to avoid them and optimize your limited study time.

It's important to recognize that the NCLEX exam goes beyond mere memorization of concepts; it requires the ability to apply your knowledge and experience to answer each question and case presented. Therefore, thorough preparation is crucial to achieving your goal of working in a healthcare institution in the United States.

• Akresh-Gonzales, J., & Simmons, L. (2022, January 5). 10 mistakes studying for the boards. Knowledge+. https://knowledgeplus.nejm.org/blog/10-mistakes-studying-for-the-boards/
• Brubaker, A. (2022, September 28). Break the multitasking habit with these study tips. Connections Academy. https://www.connectionsacademy.com/support/resources/article/break-the-multitasking-habit-with-these-study-tips/
• Joyce University of Nursing and Health Sciences. (2022, May 3). 8 Steps of NCLEX Question Analysis. https://www.joyce.edu/blog/nclex-question-analysis/
• Louisiana State University Center for Academic Success. (2021). The Study Cycle. https://lsu.edu/cas/earnbettergrades/tipsandtools/files/2021studycycle.pdf
• University of Guelph. (2023, January 10). What is SQ4R? https://guides.lib.uoguelph.ca/c.php?g=697430&p=5011752
• The Learning Center. (n.d.). Study Groups. https://learningcenter.unc.edu/tips-and-tools/study-partners/#:~:text=Many%20students%20find%20it%20helpful,of%20a%20comprehensive%20study%20plan.
• UTEP Connect. (2021, August). 6 prioritization techniques for when everything seems important. https://www.utep.edu/extendeduniversity/utepconnect/blog/august-2021/6-prioritization-techniques-for-when-everything-seems-important.html
• University of St. Augustine for Health Sciences. (2020, January 29). 10 Effective Study Techniques to Try This Year. https://www.usa.edu/blog/study-techniques/

Videos

• LSU Center for Academic Success. (2021, January 11). The Study Cycle: Study Better in College [Video]. YouTube. https://www.youtube.com/watch?v=ppPIYbe3D68

Readings

• Indeed Editorial Team. (2022, September 1). How to prepare for a board exam: A complete guide. https://in.indeed.com/career-advice/career-development/how-to-prepare-for-board-exam