References

Don't wait for the last minute. In fact, don't wait at all. I am looking for a job and I finally got a break. Someone asked me for references. They asked me for 5 of them in 24 hours!

I squirmed, called, emailed my closest, former work colleagues. I thank my lucky stars my references are good friends [and a very good professor who will hopefully be my good friend one day] but some of them, we haven't spoken in a year!

I couldn't reach some of my key references because it was summer and people were out. I lost out.

Lesson learned. Keep in touch and ask people to be references well in advance. Let it be the conversation you have before you finish clinic and follow up with that very nice 'thank you' card.

Picture from the muse. And a nice article on the right (and wrong) way to ask for a reference! 

NPTE: How do you remember your Cranial Nerves?

 

Sadly, I have been taught Cranial Nerves (CN) many times (once in neuro, once in neuro dx & management, 3x for every annual comprehensive exam, a handful of more times for practicals and then again for the NPTE) but the only time it stuck was when someone taught me this dirty mnemonic.

Oh Oh Oh To Touch And Feel Virgin Girls Vagina And Hymen. I know shame on me...but whatever sticks.

How do you remember it? My classmates love the Harry Potter Mnemonic.

Then there are all of these mnemonics.

Also, I count on my fingers when I am saying the mnemonic so if I forget the words, I remember there are O's (Olfactory, Optic, Oculomotor Nerve) and T's (Trochlear, Trigeminal Nerve) on my left hand.

On the right hand, there are CN 8 & 9 = Virgin Girls before Vagina = Vestibulocochlear, Glossopharyngeal Nerves,

Then Vagina = Vagus Nerve as the 10th CN and final finger! (A really important nerve!).

And Hymen = Accessory and Hypoglossal are the 11th and 12th nerves.

Don't forget to make your 1-page chart that briefly describes each nerve's function and how a person presents if the nerve in impaired.

Cranial Nerves	Functions	Deficits Presentation
I Olfactory
II Optic
III Oculomotor
IV Trochlear
V  Trigeminal
VI Abducens
VII Facial
VIII Vestibulococh
IX Glossopharyngeal
X Vagus
XI Accessory
XII Hypoglossal

 
Important CNs to differentiate is a person with dysfunction of Oculomotor and Facial Nerve. Every one remembers Bell's Palsy = Facial Nerve = droopy eye [and face/mouth], the person can't close their eye so they get dry eye and an eye patch is part of treatment. However, ptosis is also drooping of the eye but due to the inability to raise the eyelid because of damage to the Oculomotor nerve.

Bell's Palsy  = Facial Nerve
Ptosis = Oculomotor Nerve



Picture from Nursing Tips Tumblr.

NPTE: Take the review class

I would have taken the review class if I didn't miss the date. If I failed the NPTE in July, I would have been the first person to sign up for the TherapyEd review course.

Some PT programs go as far as including the cost of the TherapyEd course as a part of tuition. I think its a brilliant idea and arrange it so it offered at their campus.

I say take the course because their review book looks so much easier to study from. It was 1/2 the size of my review book, only 1 column and with larger font. Its an easier pill to swallow and helps you focus when you start to get lost in the bigger books. If you failed once, definitely take the course.

A woman that was interviewing me told me to take the review course. Its an art to take the NPTE, its not really about knowledge. Its about test taking skills and learning how to study for this exam. She says she sends her employees to the exam if they have not passed it. To make her point, she said some of her employees were [GPA] 4.0 students.

Picture from National Association of Writers in Education. 

NPTE: Honing in on your weaknesses

I got the official paperwork that indicates that I passed the NPTE! A pass/fail mark appeared on the Federation website about a week after my exam so I didn't have to worry for tooooo long.

One of the most important things that I did was figure out my weaknesses. The review book tells you to do this because you don't want to waste your time reviewing everything.

I'm a picky about how I did this process.

Every time I took a test, I would log in EVERY question that I got wrong in a excel spreadsheet and write in information in 3 different columns. 

1) ) area: cardio, pulmonary, medications, ortho, gait, neuro, mus, peds, prosthetics, systems, etc.
2) lesson learned: in a few words, what did you learn? IE. backward lean gait deviation usually results from weak gluts.
3) action: what topic should I concentrate on, "gait deviations," "medications," etc.

Then I would sort the spreadsheet by area and and find out in cardio, what kinds of questions am I getting wrong? My action boxes next to cardio had a lot of "arterial vs venous" entries. I kept getting questions that require me to differentiate between arterial and venous insufficiency wrong so I made a chart.

Arterial insufficiency	Rubor of dependency. Pain in WB (weight bearing). Intermittent Claudication. Pain with leg elevated bc gravity is not helping bring blood to the foot. Less pain in dependent position bc gravity is helping bring blood to foot.
Venous insufficiency	blah blah blah.

You start to build your own study notes, developed to your specific areas of weaknesses.

The spreadsheet helps you methodically go through your test questions to reveal what you need work on. Sometimes the whole NPTE felt so overwhelming but if I can see on a 1-pager the holes in my knowledge, it seemed more obvious how to attack the problem.