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Studying Tips for Optometry Students and How to Pass Optometry National Boards the First Time

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Here is a great studying strategy for optometry students who can apply these concepts to passing the optometry national boards.
Studying Tips for Optometry Students and How to Pass Optometry National Boards the First Time

Let’s be honest, the transition from undergraduate school to optometry school is pretty intimidating for most.

The classes, work load, and lack of social time can take a toll on students’ health and sanity. This article is intended to give optometry students some knowledge to help improve their grades, become a better optometrist, and free-up some much needed social time with friends and classmates.
I will include a professional paper written for a class during my time at the University of Idaho to lay the groundwork for some studying basics. Then, I’ll adapt those ideas to how I succeeded in optometry school in a fun and relatively calm fashion while still getting a solid seven to nine hours a sleep most nights and participating in weekly fun shenanigans.
The professional paper is available for download at the end of the article.
Skills that I am not teaching, but are crucial for a successful four years in optometry school are organization and time management.
A quick review that can get you started is adopted from “Getting Things Done” by David Allen:
  1. Capture: everything that needs your attention
  2. Clarify: what each item is and what needs to be done about it
  3. Organize: everything into the appropriate lists and use your calendar appropriately
  4. Reflect: on everything as needed, but most likely weekly.
  5. Engage: in getting things done based on time available, energy available, context, and priority.
It may also be advantageous to take a quick test to learn what style of learner you are. You can access a questionnaire with more information at http://vark-learn.com/the-vark-questionnaire/.
Disclaimer: I have a mild read/write learning preference.

One thing that surprised me the most from my transition from undergraduate school to optometry school was the number of laptops open during class.

Almost every single person had a laptop open typing furiously while the professor was lecturing.
There were those few classes that the professors made you close your laptops, or outlawed them altogether. Before you let angry thoughts enter your mind about those professors, they were doing it with your best intentions in mind. While laptops have made note taking much easier, the quality of our notes may be affected and semantic memories are also afflicted.
The action of writing actually helps us better to encode knowledge and facts into memory. We have to consciously think about what we are writing and oftentimes use our own words when writing notes. These insights can be applied when typing notes on a computer. Instead of trying to type every word your professor speaks, it is crucial to listen to the professor and try to type the notes in your own words and using your own semantics and language.
I admit, there were times where this was not possible, and thus it is imperative that you read over your days notes at the end of the day, each day, and make appropriate addendums and clarifications.
Tip: Reduce the amount of distractions while studying. It is important to get into a good “flow” while studying which improves efficiency. I am opposed to studying in coffee shops. The distractions are endless and the lighting is often poor. I preferred doing the most of my studies at home at a desk or table. This allowed me to have more free time to hang out with friends when I was actually doing something fun, instead of spending “social” time studying.

After we have gathered notes from lecture, we need to elaborate on that knowledge.

There are six important points we must focus on:
  1. Think about meaning
  2. Notice relationships
  3. Notice differences
  4. Form mental pictures (especially for visual learners)
  5. Space your repetitions
  6. Consider sequence positions

Thinking about meaning

If you are good at taking notes during class, you should be thinking about meaning as you are interpreting what the professor is saying.
If you are reading your notes and come across something that doesn’t make sense or is confusing, you need to look at other resources (friends notes, textbooks, websites, etc) to fill in the gaps and elaborate on the subject. Labs are also meant to help elaborate on meaning. Make sure you prepare for these labs appropriately and review results/notes from labs to accompany your classroom notes.

Noticing relationships

This is pretty self explanatory.
One thing that has stuck with me is noticing relationships between structure and function. A great example is that when diagnosing glaucoma you should closely monitor the optic nerve for structural changes that could match or explain any visual field defects (function). Try to notice relationships from within in each separate class, but also between classes. Tying everything together can make for a powerful epiphany.

Noticing differences

When determining the level of diabetic retinopathy, it is important to notice differences between each level.
Noticing differences is equally as powerful as noticing relationships. I feel like I was excellent at noticing relationships, but paying enough attention to subtler differences often eluded me. I think noticing differences is especially important when studying for the multiple choice and multiple answer questions you see in both classroom examinations and on Part I and Part II of National Boards. Noticing differences is helpful in crossing out answers you know are incorrect, which is an excellent method for taking multiple choice tests.

Forming mental pictures (visualization)

I am not a visual learner by any means, but forming mental pictures is a dynamic tool.
I utilized this the most when preparing for my clinical checkouts before entering third year internal clinic and when preparing for Part III of National Boards. Clinical proficiencies are intended to make sure that you have the procedural memory and physical capability to perform certain tasks, while also making sure you understand the semantic memories needed to interpret your findings. Procedural memories are much easier recalled than semantic memories.
For example, you never forget to ride a bike, even if there are decades between rides. But, you forget what you learned in calculus fairly quickly if you are not using it often. However, in order to make a strong procedural memory you need lots of practice in the beginning. Thus, it is important to note that I did not solely rely on visualization for preparing for clinical proficiencies in school, but rather as a compliment to hands on training.
After learning the basic components of a slit lamp, getting comfortable with one hand on the joystick and one hand on the illumination arm, and proper focusing, the slit lamp isn’t that hard to “drive.” Oftentimes, when people failed proficiencies, it was because they forgot to do a part of the requirements or forgot to verbalize something. This is where visualization can help you prepare and at the same time save you a lot of time.
You can easily visualize and consciously talk “out-loud” in your head, outlining the procedure at hand. Instead of driving or walking to the school, trying to find a partner, or waiting for an open lane so that you can use the equipment the night before a proficiency, use visualization to practice more efficiently. It is important to visualize yourself doing each step in order and to either verbalize out loud or in your head when necessary.
Try to visualize the equipment you are using and the room you know you will be performing the procedure in. This visualization technique is also very effective right before the proficiency to help calm your nerves and prepare quickly one last time (disclaimer: retinoscope and undilated 90D proficiencies come to mind as procedures that visualization may not work the best during school, but may work fine for for Part III, if you properly prepared during school).
Tip: For Part III of National Boards, I planned appropriately to have a routine, primary eye care external rotation to help practice my skills before taking the exam. I read through the outlined requirements of each section or skill and then practiced that one skill/section on as many patients as I could for a week. Then I would practice a different skill/section the next week, making sure to verbalize in my head anything that was required. Following the guidelines step by step, the same way, each time, is important to making things automatic come the big dance.

Spacing your repetitions

It is important not to study exhaustively one subject for long periods of time.
This is true for not just school, but hobbies and other learned activities. It is much better to study for 30-40 minutes multiple times a day, then for hours once a day. Use natural break activities to perform between studying sessions (exercise, social time, walks, eating etc). Your brain only has a certain amount of attention ability. This is one of the reasons that binge studying and pulling an all nighter is not the best way to obtain long term memories. Spacing your repetitions requires a good planner and exceptional time management skills and is difficult if you are a chronic procrastinator.

Consider sequence positions

Crazy enough, you are more likely to remember things at the beginning and end of a list or sequence due to what is called primary and recency effects.
Keep this in mind when planning your studies. Possible start with the most important subject, most difficult class, or the class you need to do the best on the test. Then end with the second most important subject. Frustrating enough, what you learn and store into memories after studying a certain subject can cause loss of previous memories/knowledge.
This is another reason why pulling all nighters to study does not work. You retain more of the information studied when you sleep after studying. This can be another important strategy for studying for important tests or difficult subjects. Try setting aside time to study one subject material before going to bed each night. I am also a strong advocate for naps. Don’t hesitate to set aside a 20-30 minutes power nap between study sessions.
Elaboration is a key aspect of turning knowledge from notes into long term memories.
A good piece of advice that is applicable to the elaboration process was told by Mark Twain: “It ain’t what you don’t know that gets you into trouble, it’s what you know for sure that just ain’t so.” Make sure to fact check your notes during the elaboration process and be cautious when using study materials provided or shared to you by other classmates. Using other classmate’s notes can be detrimental because they will write things that may not be in your own language and may state things a certain way that confuse you and cause damage to memories.
Lastly, the process of making these study guides themselves is studying in itself and is crucial for making long term memories.
After elaboration and divulging into the deeper meaning and bigger picture, it is important to condense materials and focus on the biggest bullet points and identify key aspects that are likely to be tested on. I liked to create a few page, bullet-point summary of each test block of material. I would often copy over key diagrams and drawings and/or key slides to my condensed review notes. You should be able to look over the notes in 15-20 minutes. These condensed notes are perfect to use for studying the morning before a test. They also make studying for the final at the end of the semester a breeze since you already have the condensed notes ready to go. Trying to go through the elaboration process at the end of the semester for a final is not going to happen. This must take place before the progress exams.
Tip: For Part II, I was confident in my schooling at Pacific University and did not purchase a prep book. I read one or two chapters in the Wills Eye Manual during lunches for about 1-2 months before my test was scheduled.
I hope that this article has given you some insight and helped you think about your own study techniques. Use this information and put them to action by incorporating them directly into your study habits.
Best of luck in the rest of your studies and good luck on your NBEO exams. Keep calm and study on!
Download the Professional Study Guide Paper
Kellen Robertson, OD
About Kellen Robertson, OD

Dr. Kellen Robertson graduated from Pacific University in May of 2016. He works at Eyes for Life in Spokane, WA where he is starting and branding a dry eye clinic from scratch. His interests include ocular surface disease and other anterior segment conditions as well as scleral lenses. Private practice and business management are two things he is passionate about.

Kellen Robertson, OD
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