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Ep #85: How to Study Intentionally and Effectively with Anna [NP Student]

I’ve talked a lot in recent months about trying new things on the podcast. Something that’s been wildly popular in particular is the content update episodes I’ve been sharing, and I’ve been stewing on more creative ideas I can share with you here as progress towards becoming a real-deal Nurse Practitioner.

This week, I’m bringing on my right-hand woman Anna to the show. Anna is one of my best instructors, and if you’ve been a long-time listener, you’ll already be very familiar with her. We’re here to share our unpopular opinions about studying, which I think will be an interesting conversation to wrap your head around as you prepare for boards.

Join us on this episode as Anna and I share the popular opinions about studying for our Nurse Practitioner exams that didn’t work for us, and what actually changed the game. We’re offering our top tips for studying in an intentional, effective, and meaningful way, and the key things that will leave you feeling prepared and confident.  

If you’re looking for support, no matter what phase of your nurse practitioner journey you’re currently in, I have communities available for both students and new nurse practitioners. In these communities, we work to uplift one another and grow this profession together every day, so click here to check them out!  

What You Will Discover:

  • Some of our most unpopular opinions about studying.
  • Why there is no need to study for eight hours a day.
  • The reason practice questions should be an integral part of your studying process.
  • How you aren’t required to know everything as a Nurse Practitioner.
  • Our thoughts on predictor exams.
  • The importance of managing your anxiety.


Featured on the Show:

  • If you’re looking for extra support, I have communities available for both students and new nurse practitioners. Click here if you’re a student, and click here if you’re a new NP!

Full Episode Transcript:

Welcome to Becoming a Stress-Free Nurse Practitioner, a show for new NPs and students that want to pass their board exam the first time and make that transition from RN to NP as seamless as possible. I’m your host Sarah Michelle. Now, let’s dive into today’s episode. Sarah: Hello, my friends, Sarah Michelle here. We’ve talked a lot in the recent months on the podcast that we’re going to try out new things this year, one of the things that we tried out that you guys really, really enjoyed are those content update episodes. We hit the top 50 in Apple Podcasts after doing a couple of those. So I appreciate all of you for that.  So another creative idea that we had to do some different content is to kind of have some more conversational-based podcasts. And so for that I am bringing my right hand woman, Anna, on the show. She is one of my absolute best instructors, always teaches live study groups with me and has since like literally the very first one. She’s been on the podcast before, but she does way more than that. And she is very much immersed in all things SMNP all the time, every day.  And so what we’re going to be talking about today are unpopular opinions that we have about studying. So it kind of gives you a little clue into what makes us different if you decide to prep for boards with us. But I think this could be a really interesting conversation to kind of wrap your head around as you start to prepare for boards, maybe you’re already preparing for boards, you know, just make sure that you are on the right track.  So Anna, you ready?  Anna: I’m ready. And I’m so excited to talk about some of these because I remember back when I was a student and I was preparing for my board exam and I had no clue where to start or what to do. And I 1,000% fell into some of these what I would say are popular opinions, which turned out to not work for me one bit.  Sarah: Yeah, I agree. That’s actually how me and Anna re-met. So me and Anna knew each other in nursing school. And then we re-met online in the Facebook study group. And Anna was like, “Here’s my calendar of exactly everything I’m doing. I’m going to do practice exams on this day, and this on this day.” I was like, “Oh my God, I’m so far behind.” I was like, “She’s got this all figured out.”  Anna: Very type A, planned out like the exact reviews I was going to do, how many hours I was going to do each day. But you all, I was a little bit anxious about my exam. I didn’t realize it. Did not realize it at the time, but I definitely was.  Sarah: Yeah, I was super anxious. And I think I could identify that at the time, actually. But I think looking back on it now I’m like, “Oh my God, I was a mess.” And I tell students, I’m like, “My hair was falling out in clumps.” And people looked at me like I had five heads. I’m like, oh, that’s not normal behavior. I was very stressed about this exam.  Anna: And that has been what has brought you SMNP reviews and why we are here today.  Sarah: Yeah, definitely, I needed a different spin on review and, obviously, I created that after the time. And I think this kind of leans into, I think, one of our most, not most, I’d say one of our biggest unpopular opinions that we hold. And that is very much the fact that you do not have to study all day, every day.  So Anna made a calendar to study all day everyday. But as she’s already alluded to, that’s not the best strategy because what happens is you get so overwhelmed and so overstimulated, you find yourself falling off track. And you’re like, “Oh my goodness, I was so overwhelmed on Wednesday, I didn’t do any of my Wednesday items. I didn’t study for eight hours that day. So now I’m super far behind.”  And then that kind of starts tying into the mindset piece of, I’m not preparing enough for this exam, even though as long as you stay dedicated, that’s really the biggest thing, and you’re consistently studying. And so what we really, really, really harp on in the live study groups in particular is we want you to do bite-sized studying.  So we never want anyone to study for eight hours a day. I don’t have the attention span for that. I’m sure you, Anna, do not have the attention span for that.  Anna: No. Let me just take you back to me studying for my exams. I had finished clinicals. I tried to do all my clinicals, I was doing 40 hours a week to finish early. I was 35 weeks pregnant at the time. I was about to move across the country because my husband was in the military at the time. And so I wanted to get this exam past me. I was like, I need to pass this so I can have my baby, so I can move, so I can do all of these pieces.  And no one at the time told me, Anna, if you study two hours a day, you’re going to be golden. You have these six weeks ahead of you that you have planned, there is no reason you need to study eight hours a day. And so when I sat there and I’m like, okay, I’m going to study eight hours today.  I didn’t have any kids at the time. My husband was working full-time and I was like, all right, while he works, I’m going to study the whole time. And within like two or three days, you get really, really burnt out. And it would come to a point where I just didn’t remember what I studied like two hours ago. It was like, what did I learn again? What was that?  Sarah: You start to forget the stuff you know.  Anna: Yeah.  Sarah: And I’m like, I really knew diabetes, and now I know nothing about diabetes.  Anna: Yeah, I knew diabetes yesterday, and I don’t know it today. And then panic. More and more panic, which then makes you forget even more. And so when I started going back a little bit and being like, you know what? I have so much time. I am planning this, I can study two or three hours a day, and that is more than enough. It changed the game for me.  Sarah: Well, you just want your studying time to be really focused, intentional time. And if you’re doing it for eight hours, there is no way humanly possible that eight hours straight is intentional, thoughtful time. Your mind is going to wander, and your attention span, and everything else. So in the live study groups we’re like, show up for an hour a day.  Now most people, I will say, they show up for their hour of video or whatever a day. And then they spend maybe another 30 minutes doing practice questions or something like that. But that really, like if you commit yourself to it, is all you need. But nobody ever wants to hear that.  Anna: No one wants to hear that. And what I found when I was putting that into practice is like, yes, I had an hour of assigned things a day. But that gave me the flexibility to relisten to the review course, to take notes over the things I was confused on, do further research if I needed to, and do practice questions because I was alert and I was mentally engaged and I could retain it. And it made those probably two, max three hours some days so much more meaningful than those few days I had spent eight hours just cramming and stressing.  Sarah: Yeah, and I think there’s a big important thing to remember here too. And I say this all the time, and maybe this is an unpopular opinion itself. But if you have graduated from nurse practitioner school, you can pass this exam. You already have the knowledge base. And this is where people start throwing excuses at you and you’re like, but yeah, my program did this or this wasn’t that stringent, or whatever else.  Throw all that stuff out the window. If you have graduated from nurse practitioner school, you’re ready to take this exam. And board prep, ideally, it’s just the icing on the cake. Like it’s the thing you’re doing at the end just to really firm up that confidence and make sure you’re ready to roll, but you had it all there to begin with.  Anna: Oh, absolutely. And looking back on it, what review courses and what board prep did for me was put it all together. Like I had this content, I learned this content over years of school, but I just maybe didn’t remember it or I hadn’t put all of that pathophysiology and all of that pharmacology into these differential diagnoses. And then being able to apply it on the exam, which I think goes into another unpopular opinion, where practice questions are so critical.  Sarah: Oh my God, yes.  Anna: Because you have all of this knowledge and you can do a review course and feel so confident in the content. But until you start practicing actually critically thinking through questions, weeding out the fluff that exam questions love to put in, you’re not going to be fully prepared.  Sarah: No, and you can think you’re fully prepared, then all of a sudden you do a practice set and you’re like, “How did I get a 40%? What just happened to me?”  Anna: Yes.  Sarah: And so I think it’s just a really good way to get a perspective on how things are going to be asked. Are there important things that you didn’t pick up on as you studied or you don’t remember from school, like they’re not as fresh? And so it just gives you this really wonderful opportunity to highlight, okay, I do know this, but I really need to study this over here more.  So I love, love, love practice questions. That will forever be the hill I die on because a lot of reviews out there are like, “Well practice questions are okay, but they’re not the main thing you need to do.” And I think they are absolutely an integral part of your entire studying process. They should be almost an everyday thing. You know, you watch a video, you do practice questions. Like you follow up right behind to make sure you’re actually ingraining that material.  Anna: Yeah, absolutely. And I want to throw in there it’s okay, especially like you were saying, if you get a 40% on a practice set, it’s okay. You want to take that and you want to learn from it. And that’s what they’re for because I would rather any student get that 40% in the practice set than on their actual exam.  And the more you do it, the easier they become. You start learning how they’re worded. You start learning how to dissect those tough questions and not get so anxious when a really tough question that you’ve never heard of pops up. Because I was definitely that person who would start overthinking and I’m like, “Is it A? Is it B? Is it A? Is it B?” And then any ability to critically think was lost.  Sarah: Yeah, and I think you bring up a good point, too. I always talk about this but I’ll say it again for any fresh students out there. The very first question on one of my exams was something I’d never heard of. So it allows you, when you’re doing practice sets and something pops up and you’re like, “Oh my Goodness, I really know nothing about this topic. Was this in the review? Did I learn this in school?”  It lets you practice that loop ahead of time, so that way on your exam day when it happens you’re like, “Oh, this is normal and expected. This shouldn’t fluster me. This is just one question. This might be a trial question.” Whatever your strategy is going to be. But if you don’t practice that skill to begin with, it’s really easy to get lost in the panic on exam day.  Anna: Yes.  Sarah: And we know so many students this has happened to. This is like my least favorite thing. I’m like, okay, you come to the anxiety review, you have to practice your skills ahead of time because you don’t want to let this blindside you on exam day. You just want this to be normal and expected, like this is a weird question, that’s okay. This is normal.  Anna: Absolutely. And you don’t need to know. You don’t need to know every single question to pass. You, in healthcare, are never expected to know every single thing. You’re never going to be able to, especially when healthcare is just always changing and the knowledge is so vast.  Sarah: Yeah, I feel like it changes every day, which is such a pain point for our students because they’re like, well, which guideline are they going to use? And what about this or this scenario over here?  Anna: The million dollar question.  Sarah: Oh my God, the million dollar question. That’s the billion dollar question, actually, because the exams are just a little bit behind. And that’s okay, but we have to be able to be prepared for that too. And I know that’s a massive source of anxiety for students.  Anna: It is a massive source of anxiety. But I always try to remind students, like at the end of the day they want to know are you going to be a safe and competent new nurse practitioner? That is what those exams are getting at.  Sarah: Yeah. And I think too, students just have to continually remind themselves of what you already said, I don’t have to know everything. And I think a really good tool here is I only need to know about 70%. Because that gives you so much leeway when you’re sitting and looking at a 150 question or a 175 question exam. I only have to know 70%, there are pretty good odds I’m going to pass this exam.  And then the other thing you can kind of rationalize in your brain with, over 85% of people pass this exam. So the overwhelming majority pass. Even when you’re like, “Oh, my friend failed.” Well, odds are you’re going to pass, odds are.  Anna: Yes, yes. And kind of another unpopular opinion that I feel like goes along with all of these practice questions that I personally have, I don’t like predictor exams. I do not think predictor exams predict your success on the exam.  Sarah: Yeah, I’m always torn on predictor exams. I think the SMNP side of my brain, I want to create something that can be truly predictive in the future. But until we get to a point with software or AI or something really cool where it can really be predictive of success, I very much hate predictor exams.  Anna: Yeah, all the ones that exist today, at least I remember right before I did my exam, and y’all this was a mistake, don’t do one right before your exam. Take the day before off. But I did one the day before my exam because I’m me. And I think I scored like 50% on it.  Sarah: That’s scary stuff.  Anna: Yes, absolutely panic.  Sarah: That would have me totally psyched out.  Anna: Yes, absolutely panic. And then I got into my exam and I was like, “Okay, now, I’ve got this. That was an outlier, you can do this.”  Sarah: Yeah, I remember my predictor exam from school and I got what I needed, I think it was like a 70 or 75%. I literally got exactly what I needed to pass. And then I took AANP and I got almost a 90% and I’m like, I was well prepared for this exam. Was this predictor actually predictive? Probably not, but it was definitely more anxiety for me than anything else to do a predictor exam.  Anna: Yes. Yes, I agree. And hopefully, right, hopefully the future is bright when it comes to those because there are so many cool things out there with AI and new software is coming out. And that would be my vision, is that you could have such a true experience of the exam before you actually take the exam. But I don’t think people are quite there yet.  Sarah: Yeah, I don’t think we’re there today. And I think in a lot of ways we’re the new age of review courses. So there’s a lot of archaic ways of doing board prep. And we’re on the cusp of doing it a lot differently all the time and we are very different in our approach and how we think about things and how we present our courses. And even just like the style in which we present. So I don’t want to rule out predictor exams forever, but at least for now they’ve got to go.  Anna: Don’t do them. We are definitely on the cusp of innovation, I feel like.  Sarah: Yeah, for sure. I think another big unpopular opinion that I have is that you can literally know all the content in the world and it does not matter one bit if you can’t manage your anxiety, like if you don’t have that solid plan in place. Because I know there are people out there and they’re like, “If you fail, it’s on you. It wasn’t the anxiety.”  That is not the case because there are lots of wonderful students out there who have failed that are very diligent. You know, they got straight A’s in school. Like they are the ideal student to go and pass the exam, and they don’t. And so definitely that anxiety component is going to play a major factor if you’re not ready to manage it.  Anna: Yeah, and that was huge for me. Some backstory on me, and I’ve talked a little bit on social media about this, but I was that student. My A minus in my theory class still kills me to this day because it was the only thing that messed up my GPA for NP school. But I have been very fortunate where I haven’t struggled with a lot of testing anxiety in the past, and I’ve made it through nursing school and I made it through NP school.  And so preparing for my exam, like looking back the signs were there and it was obvious. But I didn’t really realize it at the time and so I never practiced that anxiety plan. I never had any plan in place, or even thought that would be a factor. And I’m not kidding you when I tell you, I woke up the morning of my exam like palpitations, physically nauseous, my mind was just racing. And I was not prepared for that.  And I started that exam so, so anxious and blindsided. And those first few questions, it was like a foreign language to me. And luckily, I was able to kind of put a plan in place that day, but I so wish I had practiced it. I mean, my first hour of my exam could have been so much more productive. I had to skip so many questions to get to just some confidence booster questions and get in my groove.  And once I did that, I went back to those first few questions and I was like, “Wow, Anna, these were obvious questions. You knew this.” And so thank goodness I had just skipped them and I had moved on and I found my groove and found my confidence. But it can derail even the most prepared of students even if you don’t expect it or if it’s never been something you’ve struggled with in the past.  Sarah: You’ve got to go in with a plan. Fortunately or unfortunately for me, which, Anna, you’re intimately familiar with this, my exam was rescheduled like four or five times. And when I say rescheduled, like the first time it was rescheduled, so I had a testing center in person in Louisville where I’m going to. I go a couple of days before I get this email, like you’ve been rescheduled. I opened up my email, I was literally rescheduled in Dubai and there was no way.  Anna: I remember that.  Sarah: Yes, the system was down, I couldn’t get it out of Dubai. And it wasn’t like Dubai online virtual. It was literally like a testing center in Dubai. I have no idea how this humanly happened to me, it was so much chaos. But because my exam kept getting rescheduled over and over –  Oh, there was the time I was on 30 minutes before, I was going to take the at home exam, but it also got canceled. And literally, I didn’t know if I was going to be able to sign up again because it locked down my account. Literally someone in a Facebook group sent me a random back-end chat link Prometric to get rescheduled. But otherwise, I think I would have sat for weeks because I couldn’t get anybody to call me back, email me back. So anyone out there experiencing that, I have felt all of that.  Anna: Yeah, I remember you had a nightmare. It was a nightmare experience for you.  Sarah: When I say it out loud, it feels like I made it. I’m like, it doesn’t even sound true. But that’s like all the craziness I experienced just trying to get into this exam. But because I tested two weeks later than I had hoped to, it gave me a lot of time to realize like, oh, I’m super freaking anxious. I don’t even know what I’m going to do with myself when I get an exam.  So I had already started to formulate some of that anxiety game plan just out of necessity, because having to deal with my anxiety at the house just like every day, every time I would get amped to take it and they’d be like, “No, you’re not taking it today.” I’m like, “Why are you doing this to me?” Anna: I just need to get it over.  Sarah: Yeah.  Anna: I tested back at home when they offered that. And I am so thankful that they don’t offer it anymore, one. And two, that I had found my groove before I ran into any issues. I mean, this was like the first week of them offering at home testing. And all the testing centers by me were closed down and I was almost finished with my exam, Sarah, almost finished. And the whole system kicked me out.  Sarah: I would have had a stroke. I literally would have fallen on the floor. Anna: And I couldn’t reconnect with my proctor. I was like, am I allowed to leave my room right now? I’m 35 weeks pregnant, I need to pee, and like this whole rabbit hole. But thank goodness I had found my groove, I felt pretty confident. I was able to, finally, like after 20 minutes I just exited the whole thing and restarted and it luckily, thank goodness, thank my lucky stars it saved my progress.  So all was well. But you need to have that anxiety plan because you just never know what’s going to happen. I did not prepare for that.  Sarah: Yeah, you can do every review course out there and it doesn’t matter if you can’t manage your anxiety. And that sounds so goofy to say, like to be that prepared and go in and fail. We’ve just seen it happen so many different times again and again to students. And that’s like my least favorite students that come to me. Not because I’m upset with them, but I just feel so deeply for them because I was probably dangerously close to being that student.  Anna: And that’s another unpopular opinion when it comes to reviews, like you don’t have to do every review course available. The more you do is not better.  Sarah: No, you want quality over quantity. And I know people say that and it’s cliche and all that sort of stuff. But I genuinely mean it. You want to commit yourself maybe to one or two reviews at the very most. Any more than that and you’re like, “But wait, this one said this. And this one says this. And what about this over here?”  You need to pick a source of truth for yourself and lean all into that source of truth, because otherwise all it does is just screw around with your confidence. And then when you’re not feeling confident you have more anxiety, and you have more anxiety. It just creates this endless loop.  Anna: And you have to think, there are so many gray areas in healthcare and the exam is not going to focus on those gray areas. But that’s where students tend to go down these rabbit holes when they’re doing so many different review courses. Like I did this review course and it has guidelines from three years ago. And I have this review course which is more updated. And then I’ve had this review course, which has this little part of a gray area, but this one has a different interpretation.  And it just can be so confusing for students to pick out what they actually need for the exam. And it just harps on that confidence piece.  Sarah: Over and over. And this is my shameless plug too, you want to be doing reviews that keep up to date.  Anna: Yes.  Sarah: And so we update our stuff annually, every single year. And when I say we look at every piece of content, we’re looking at every word of every piece of content, like does this still make sense? Has this changed? What’s going on in the exams? We definitely have a pulse on the exams from our Facebook community, if anyone has ever lived there. I feel like we have a constant pulse on the exam and what people are experiencing.  So you really want to find a review company that stays up to date so you know you won’t be in the dark when you walk into your exam too, I think that’s really important.  Anna: Yeah, and it’s not only things like guideline updates that are constantly changing, but I mean the exams are updating too.   Sarah: Yeah, formatting.  Anna: Yeah, the FNP exam recently, especially that ANCC recently just had a huge, huge update. And then, for example, all those AANP exams are now in a completely different testing software.  Sarah: I’m so excited about that.  Anna: I am too, you get all those new features like highlighting and striking out, which are my absolute favorite. And so just staying up to date with those types of things can make all the difference.  Sarah: Yeah, I feel like that can be really make or break because you walk in expecting one thing, and then all of a sudden you get something else. And that is so flustering in itself, it doesn’t even matter what the exam question said because now you’re thinking about this over here. So definitely being up to date will be your best friend. So live in our Facebook community. Shameless plug for the Facebook community.  Anna: Live in our Facebook community.  Sarah: Unless it makes you anxious, then take a step back.  Anna: But overall, I feel like our Facebook community is a super, super awesome, supportive place and even things like, “Oh my gosh, my exam had so much non-clinical.” Well, then we update our courses and we put more non-clinical content in there. It’s so important to stay in touch.  Sarah: Yes, just don’t get lost in the Facebook group, and remember too – Now I’ve got caveats. Everybody has a different exam experience and what’s the hardest exam to you is the easiest exam to me, all those sorts of things. Just keep those rolling in the back of your mind.  Anna: Yes, just because my exam kicked me out halfway through it, does not mean yours will, I promise.  Sarah: Amen. Or just because I got a weird fluky question in my first question doesn’t mean that your first question won’t be the easiest question you’ve ever read.  Anna: Yeah.  Sarah: Well, Anna, I think this was cool. What do you think?  Anna: Yeah, I really liked this.  Sarah: Live feedback.  Anna: Live feedback. As a student, I would really appreciate this. And I wish there was someone just to tell me I don’t have to study eight hours every day. I don’t have to do six review courses. I don’t have to do all of these things and overwhelm myself and be so anxious and stressed to be successful.  Sarah: Yeah, but you should do practice questions.  Anna: Yes, yes, yes, I know. I wish somebody told me to do more.  Sarah: Yeah, same.  Anna: I love practice questions.  Sarah: I wish I had more avenues for practice questions, because I had exhausted the ones I had. But yes.  All right, cool. Well, to those of you out there listening to this episode, if you really liked this, let us know on Instagram, or a review, or the Facebook group, or anywhere that you want to let us know because maybe we’ll do more of them in the future. But that is it for this week.  As an extra bonus, friends, if you’re looking for support no matter what phase of your nurse practitioner journey you’re currently in, I have communities available for both students and new nurse practitioners. In these communities, we work to uplift one another and grow this profession together every single day. Links to join will be included for you in the show notes.  Thanks for listening to Becoming a Stress-Free Nurse Practitioner. If you want more information about the different types of support we offer to students and new NPs, visit See you next week.

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