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What Comes First … the Photo or the Text?

Question from Five Keys participant: “Should I look at the photo first, or look at the question first?”

I could make an argument for either approach. I’ve spent much of my career with one foot in the clinical camp while the other foot is in the academic camp.  How I approach a test item depends, to a degree, on what kind of camp I need to be in to answer the question.

If I was in front of a patient who had a question about her sore nipples, I would listen to her question and then look at her nipples. Generally, in the real-life clinical setting, I first hear the question posed and then I get to see the situation–whatever it is–myself. I do not see the patient and say to myself “I wonder what this problem is?” I don’t see the nipples or the incision or the lochia or jaundice first and then say, “Gee, I wonder what she wants to ask me about this?” So, in general, I suspect I’m better at looking at photos after I’ve taken in the question. That gives me a sense of context.

But as an educator, I do sometimes find compelling photos and think “Oh, this is an interesting photo. I bet I could cook up a good question on this.” I bet the same thing happens to IBLCE exam writers!

When I’m taking the IBLCE exam, I sometimes do try to examine the photo first, so that I read the question in the context of the photo.  If I can do that successfully, I’m usually much quicker at answering the question. The only downside: This approach can backfire on me if I focus on the baby’s nose, and discover that the question is about what’s on his forehead!

Ultimately, reading the question first feels more clinically comfortable for me, and it may improve the accuracy of my initial thinking. However, if I focus on the right thing and recognize what’s going on in the photo, seeing it first can improve the speed of my answer.

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