single best answer

If you’re in a clinical subject, such as Medicine or Dentistry, you’ve probably heard of Single Best Answer exams. These exams tend to count for quite a high percentage of your grade, and they can seem trickier than typical Multiple Choice questions.

Before we start, what exactly are Single Best Answer questions? Simply put, they’re a type of Multiple Choice question where all the answers are technically correct, but only one of the answers is “best.” These questions typically test your clinical reasoning, and they ask questions such as “What is the best investigation?” or “What is the best treatment?”

These types of questions can be challenging at first, but in this resource we’ll highlight seven strategies to help you prepare for Single Best Answer exams.

1: Read the Question

It might sound obvious, but it’s worth a reminder: read the question! Often, SBA questions hinge on a single detail, such as the patient’s demographic or medical history. Make sure to read the question at least twice and watch out for details that could be important.

That said, sometimes the question will include information that’s not relevant, so don’t feel like you need to account for every single detail when deciding on an answer.

2: Use the ILOs

Every course will have Intended Learning Outcomes that list what you should know by the end of each year. All your assessments will match up to these ILOs, so they’re an excellent way to know what to revise.

When using the ILOs, pay special attention to any that won’t be assessed anywhere else. Practical ILOs will often be covered by things like OSCEs, but many areas of knowledge can only be assessed through an exam, so focus your revision on those.

3: Focus on the General

By nature, SBA questions tend to focus on the general, rather than the specific. After all, if you’re asked about the best treatment, and all the answers are potentially correct, what you’re looking for is the solution that is most likely to work in the majority of cases.

In your revision, then, focus on patterns, not outliers. You’re looking for the answer that is most likely, not any that could be possible.

4: Focus on Understanding

With SBA questions, it’s important to focus on understanding rather than memorisation. The questions will often involve multiple stages, such as combining a patient’s symptoms and medical history to work out a diagnosis, then suggesting the best possible treatment. In these cases, it’s essential you fully understand the condition, rather than just memorising a few facts.

This type of understanding is called “Clinical Reasoning,” and it’s an essential part of being a good clinician. Basically, these exam questions aren’t asking, “Do you know the answer?” they’re asking, “Can you work out the answer?”

5: Make Connections

Clinical reasoning is all about putting information together to identify the best way to proceed. This means your revision needs to focus on combining ideas, rather than just memorising facts. A good clinician will understand how different information fits together.

One way to do this is to combine different ILOs, or different sections of your course. You might choose two ILOs and ask yourself how they intersect, or pick two lectures and explore how what you learned one week impacts what you learned the next. Revising this way should unearth some interesting connections, and it will also train your brain to bring different aspects together.

6: Use Scenarios

SBA questions often rely on scenarios, so it’s a good idea to use them in your revision. Try writing a scenario for yourself, such as, “A 5-year-old female presents with pain in her jaw…” This strategy can work particularly well in groups, as everyone can take turns presenting scenarios and you can discuss them together.

To make this strategy even more effective, try modifying your scenarios. Add or change details and see how that might change the answer. You can also try writing your own answers; see if you can come up with some good options that are correct but not “best”!

7: Understand Effective Revision

While SBA exams might sound quite different from other kinds, the reality is that most effective revision strategies are fairly universal. To do your best on exams, it’s important to understand principles like active revision, recall vs. recognition, and the importance of continuous revision.

If any of those terms are unfamiliar to you, we recommend you check out our Revision Bites resource. This resource contains many of the most effective learning strategies that will help you on any type of exam.

Conclusion

In this resource, we’ve covered seven different strategies for revision for SBA exams. This format is new to many students, but its focus on understanding rather than memorising will help you develop the skills you need to be a good clinician. If you use these strategies and focus on developing your clinical reasoning, you’ll soon become much more adept at picking out the “best” response.

Top Tips

Focus on understanding, not memorisation. This holds true for any kind of exam, but it’s important to state here because we often assume that multiple choice exams are more focussed on memorisation. If we just store a few key terms in our minds, surely we’ll recognise them on the exam, right? The difficulty is that the exam might use different vocabulary to what we expect, or it might ask us to apply our knowledge. In this case, it’s better to understand the concept, rather than just know a few key terms.

Use question banks, but not exclusively. If your course provides question banks or past papers, use those to get a sense of the types of questions that will be asked. You can also use them to test your knowledge, but make sure you supplement this with other methods. Otherwise, you’ll know the material from the questions, but you’ll have significant gaps elsewhere.

Create your own questions. This method can be time-consuming, but it works well for focussed study on particularly challenging areas. Spend some time coming up with your own questions and writing answers– including wrong ones! Creating answers that are wrong but plausible will deepen your understanding of the subject.

Single Best Answer

In certain disciplines, such as medicine and dentistry, you’ll come across a particular type of MCQ called “Single Best Answer.” This kind of question is particularly challenging because all the answers are potentially correct, and you need to choose the one that’s best. Here are a few revision techniques that are especially helpful for these questions (though they’ll be valuable for any MCQ exam).

Study the wrong answers in question banks. It can be tempting to just answer a question, get it right, and move on. To get the best use out of your question bank, however, you should also explore the “wrong” answers. Since all the answers in a SBA question are technically correct, you can learn a lot by working through each one and asking yourself, “why isn’t this one best?”

Focus your revision on recall, not recognition. Recognition is where you recognise something when you see it written down, while recall is where you can pull information out of your head. Recall is essential in SBA questions because every answer will have key words we recognise. We need to be able to pull the correct information from our brains, rather than just choosing the answer that seems familiar. In your revision, then, you should focus on actively testing yourself, rather than just reading or re-writing notes.

Explore connections between topics. Particularly in upper years, SBA questions will often ask you to pull together information from various parts of your course. In your revision, then, it’s helpful to create diagrams or mindmaps that show how different topics link together (bonus points if you make this activity recall-focussed by creating the mindmap from memory, then using your notes to fill in the gaps).

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