Table of Contents Links for authors Reviewing questions reviewing checklist instructions on reviewing questions reviewing team Writing questions Step 1 Qbank team Step 2 Qbank team Writing a question format Lab value format examples Updating topics updating checklist Illustration creation guidelines Responding to member comments Helpful tips Symbols to use Requesting a topic to be created Payroll Policy Links for Authors Illustration Creation Queue Step 1 Qbank Tested Concepts Step 2 Qbank Tested Concepts Content Team Instructional Guide Content Team Updating Topics Manual Laboratory Values Imaging Database Reviewing Questions C1: Question Stem & Complexity: Is the TC tested and medical information accurate? C2: Diagnosis/Correct Answer: Is the diagnosis and the correct answer stated? C3: Explanation Section: Is the information presented logically? C4: Question Stem/Explanation Images: Are the images high quality and non-copyrighted? C5: Incorrect Answers: Are they thoroughly explained? C6: Bullet Summary: Is this information presented in a high yield, concise manner? C7: Level of Difficulty? Rank the question out of 10. 1 = too easy and 10 being difficult. C8: TC & Question Icon: was the Tested Concept and the question icon added to the topic? To find definitions for Medbullets LOE: https://step1.medbullets.com/stats/106033/level-of-evidence Reviewing Checklist Copy/paste this version into your comment box when reviewing questions Level of Review: Status: C1: Question Stem & Complexity: C2: Diagnosis/Correct Answer (1-2S max): C3: Explanation Section (~4S): C4: Question Stem/Explanation Images (1-2S per image): C5: Incorrect Answers (1-3S per answer):C6: Bullet Summary (1S max): C7: Level of Difficulty (1 - Easy & 10 - Hard): C8: TC & Question Icon: Instructions on Reviewing Questions Anyone on the reviewing team can be the first review FIRST REVIEW immediately post the comment: "Under First Review" you will have 1 hour from the time stamp to review the question otherwise the questions becomes available for any other member of the reviewing team to review the question DO NOT make any major corrections yourself, you must make the author make the corrections unless they are minor spelling errors in the case of minor spelling/grammar errors, YOU MUST MAKE COMMENTS in the appropriate sections if you don't do this, then errors just propagate without being fixed after the first review, the first reviewer will send it to two other people for the second review only one person can review it. SECOND REVIEW the first person to get to the second review must post a comment "Under Second Review." you have 1 hour from the time stamp or another second reviewer can review it, but DO NOT start reviewing until after the 1 hour and you have posted a comment there will be no credit for the second review if you go over 1 hour and another second reviewer reviews it the first time stamp to approve will receive the credit now do not start reviewing the question until minute 61 and do not approve immediately as a 1 minute review indicates that you didn't actually review it you must be a level 2 author to be a second reviewer (some exceptions may occur) when you are finished, send it to Chris Robinson and state DO NOT REVIEW FURTHER Commonly Missed Items REVIEWING PROTOCOL when you start to review, IMMEDIATELY save a comment stating UNDER REVIEW first reviewer means you are actually the first one to review first reviewer does the heavy duty reviewing second reviewer means you are actually the second to review second reviewer is supposed to check for the medical accuracy and if the vignette is plausible all reviewers should always check the grammar you should never feel guilty for flagging a question/posting an EA catch mistakes earlier and the reviewing process becomes easier and faster always paste the checklist if you are using a mobile device or ipad you can use the abbreviated form of R: 1 or 2 S: A or E 1Y/N 2Y/N, etc. all second reviews should send a message to Chris Robinson after the review is complete Hypens should be used for ages: e.g., 58-year-old female Explanation/Strategy paragraph: should be 1 paragraph with 4-8 sentences variations are permitted in certain cases if you are using a list then you can add a space above and below the list if you need to introduce the list and conclude after the list use this sparingly Until our developers create the feature that allows us to insert the descriptions into images please resume the use of Figure and Illustration use Figure for images in the question stem use Illustration for images in the explanations always check the website and image for the copyright status of the image images should be high quality (i.e., not blurry) Vitals should always be in the USMLE format: temperature is X°F (also put in parenthesis the Y°C and vice versa), blood pressure is systolic/diastolic mmHg, pulse is x/min, respirations are x/min use symbols when you can, they can be located at the bottom of this page sub- and superscript do not work in the questions, but others do only copy from the view topic mode Use of references should be used when information is new (< 5 years old, e.g., DSMV, HCV treatment, etc.) controversial (ethics) Bullet summary should be concise and straight to the point never longer than 1 sentence, the shorter the better; otherwise put it in the explanation should not be a copy and paste of info in the topic or explanation Miscellaneous when using the Genus species name of an organism, capitalize the G first word in each answer choice should be capitalized the only time that a lowercase is used as the first letter is when an abbreviation is used that is lower case (e.g., ssRNA viruses, etc.) incorrect answers should be closely related and not be obviously correct or incorrect diseases should only be capitalized if they are a proper name (syndrome and disease should rarely be capitalized Reviewing Team M1 Reviewer Damian Apollo Don Li Moises Dominguez Lucy Liu Drake LeBrun M2 Reviewer (Final Reviewer) Chris Robinson L1 Reviewer Richard Kim Chen Yan Jason Wink Step 1 Qbank Team Team Leader Don Li Authors Drake LeBrun Alex Sun Sila Bal Moises Dominguez Step 2 Qbank Team Team Leader Damian Apollo Authors Iris Lee Richard Kim Kimberly Shao Meredith Case Moises Dominguez Content and Illustration Team Team Leader Moises Dominguez Authors Drake LeBrun Lucy Liu Michael Mattiucci Illustrators Lucy Liu Moises Dominguez Vanessa Dudley Writing a Question Format Updated question format (2/6/17): You will notice that there are length requirements, we want to make sure that our questions test only 1 concept. So don't cover the entire topic. Make sure your explanations flow and the tone is very professional and appropriate for the USMLE Step exams. We are raising the bar for our questions and we ask you to post error alerts if they are not high quality questions or questions are below a 5 in difficulty. Similarly, do not approve questions if something is missing, it can be improved, if it is low quality, or you have suggestions. Please do not deviate from the Tested Concept (TC), but if you do feel the TC is not accurate or could be altered please contact your team leader. Remember your name is associated with these questions, so they are your work of art! If you have any suggestions or ideas on how to improve it, please email me at personnel@medbullets.com – I want to hear them all and many times we implement your ideas. For video explanations, please click on the links below how to write a question how to link a quesiton C1: Question Stem & Complexity (note: recommended length is in parenthesis) did you deviate from the Tested Concept? is the medical information/clinical vignette accurate? is the question complex with multiple layers of difficulty? are there grammatical errors? are the answer choices related? are there answers that are obviously incorrect or correct? an EA should be placed on ALL questions that are obviously too easy or do not test the Tested Concept if there are errors MAKE THE AUTHOR correct it vital signs should be in the following format: temperature is X°F (also put in parenthesis the °C and vice versa), blood pressure is systolic/diastolic mmHg, pulse is x/min, respirations are x/min example: the patient's temperature is 100.1°F (37.8°C), blood pressure is 120/70 mmHg, pulse is 60/min, and respirations are 15/min C2: Diagnosis/Correct Answer (1-2 sentences) reinforce the answer through repetition state what is the diagnosis and correct answer. Feel free to add the symptoms that lead to the diagnosis. do not review the topic here but state in a manner similar as the following below: "The clinical presentation is consistent with chlamydial infection during pregnancy. The most appropriate first-line treatment is azithromycin for the pregnant mother AND sexual partner" C3: Explanation paragraph (~4 sentences) You only want to discuss the one item tested from the tested concept. Do not cover the entire topic. Optional Reference: references are NOW OPTIONAL and should only be included when the data is new (< 3-5 years old) or controversial DO NOT POST IRRELEVANT REFERENCES - they will be removed C4: Illustration/Figure paragraph: 1-2 sentences per image only put images that are high quality images and provide a clear explanation of the image You will only be compensated for a max of 2 images per question the best images are clinical photos, histological specimens, radiographs, MRI’s, CT scans, etc do not post flow charts, powerpoints, or figures from journals. We would need to request permission from the journal make sure that the image is not copyrighted by checking if there is a copyrighted symbol on the image or if the webpage is copyrighted always start the paragraph with the description of what the image is Figures appear in the question stem while Illustrations appear in the explanation Don't ask why, they just do note: Figures and Illustrations are always capitalized regardless of where they appear in the sentence where you place the URL of the images makes a difference where it appears paste the URL in the image text boxes to make the image appear within the question as a Figure paste the URL in the illustration text boxes to make the image appear within the explanations as an Illustration Example for how to describe the image in both the question stem (Figure) or explanation (illustration) Figure A is a radiograph showing a femur. Illustration A is a schematic of glycolysis In the next few months, we will then copy these descriptions into the new testing interface C5: Explanation paragraph: incorrect answers (1-3 sentences per answer) multiple choice section (this is right below the question stem): keep the answer to one line so that it does not wrap around as a second line when you are in member view really think about the incorrect answers, they should be related to the correct answer in some way and not completely obvious incorrect answers if you were the reader, what kind of question would you want to help you prepare for the exam? explanation section: 1-3 sentences per answer this is the time to really explain why this answer was incorrect or what could have made the answer correct if something were changed your name is associated with these questions and topics it is your work of art and we feature questions on the main page periodically if you write better questions and explanations there will be fewer revisions and error alerts take pride in the questions you write formatting Incorrect Answers Answer 1: Answer 2: note: the I and the A in the Incorrect Answer header should be capitalized; this is commonly forgotten it is fine to lump two or more incorrect answer choices together but not recommended, for example: Answers 1 and 2: BUT it is better to explain each answer as this is another area where our members can learn C6: Bullet Summary (1 sentence) highest yield fact and takeaway from this question no additional information should be presented in this section but rather it should serve as a quick take-away for members who are reviewing the question basically, if you had one minute, what is the highest yield fact that you want to leave the reader C7: Level of difficulty though this is subjective, if we were to rank questions out of 10, on average we would want questions to be 7-9/10 questions below a 5 should be flagged we need to be different than all the other Qbanks they can't all be 10/10 C8: TC & question icon added add the question icon to the appropriate topic, and make sure that the one item tested in the question is added to the page for instructions how to add a question icon, please see this video For an example, see the following question Tips on writing questions alphabetical order answer choices should be in alphabetical order 1 best answer questions should contain only 1 best answer spectrum of correctness remember that answer choices should be in a spectrum of correctness no negative questions do not use prompts such as "All of the following are true EXCEPT" or "Which of the following is NOT..." cover test good questions should allow the test-taker to answer the question without looking at the answer choices I should be able to cover the answer choices with my hand and still get the answer correct if I have the necessary knowledge the patient title when writing questions, please do NOT use male or female please say man, woman, boy, girl, or use their title (nurse, student, etc.) acronyms always write out acronyms before using it order of question always put the reason for the patient encounter first, then add HPI, followed by PMHx, medications, allergies, etc. possessive form of diseases we are dropping the 's for all diseases named after people for exceptions please see this article by the AMA Lab Value Format Examples (Copy and Paste and Fill in the Values) Example 1: Hemoglobin: g/dL Hematocrit: % Leukocyte count: /mm^3 with normal differential Platelet count: /mm^3 Serum: Na+: mEq/LCl-: mEq/L K+: mEq/LHCO3-: mEq/L BUN: mg/dL Glucose: mg/dL Creatinine: mg/dL Thyroid-stimulating hormone: µU/mL Ca2+: mg/dL AST: U/L ALT: U/L Example 2: Leukocyte count and differential: Leukocyte count: /mm^3 Segmented neutrophils: % Bands: % Eosinophils: % Basophils: % Lymphocytes: % Monocytes: % Example 3: Serum:Na+: mEq/L Cl-: mEq/L K+: mEq/L HCO3-: mEq/L Urea nitrogen: mg/dL Glucose: mg/dL Creatinine: mg/dL Alkaline phosphatase: U/L Aspartate aminotransferase (AST, GOT): U/L Alanine aminotransferase (ALT, GPT): U/L γ-Glutamyltransferase (GGT): U/L Urine:Epithelial cells: # Glucose: negative or positive WBC: #/hpf Bacterial: none, occasional, Example 4: Leukocyte count and differential: Leukocyte count: /mm^3Segmented neutrophils: % Bands: % Eosinophils: % Basophils: % Lymphocytes: % Monocytes: % Hemoglobin: g/dL Platelet count: /mm^3 Mean corpuscular hemoglobin concentration: % Mean corpuscular volume: μm^3 Reticulocyte count: %Lactate dehydrogenase: U/L Updating Topics C1: Snapshot every topic should have a short clinical vignette there is no need to state the diagnosis as it is evident that the diagnosis is the topic if there are multiple topics being discussed on the page, then you can state the diagnosis but put the (diagnosis) in grey and surrounded by parenthesis at the end of the clinical vignette how to make font grey either highlight the text or you can create new text after applying the font click on the drop down arrow for the font colors click on more colors in the text box type in #848484 click apply C2: Content/Grammar is the medical content accurate and up to date? did you add or remove content? make sure there are no grammatical mistakes or formatting errors do all vital signs and lab values have units? (See previous section for vital sign format) check off the box at the bottom of the page - "Formatting & Spell Check" note: MB capitalization format is that only the first word in the highest priority bullet is capitalized; all lower priority bullets are not capitalized unless it is a proper noun please make sure the topic reflects this C3: Images/Videos is the pop out function enabled on all images? If you click on the key image or even a camera icon () does an enlarged image appear? do the images have a description? check off the box at the bottom of the page - "Questions & Images" note: make sure to check all question icons are working as well (See next criterion) are there videos? If so, do the links still work? check off the box at the bottom of the page - "Videos - Youtube, Vimeo" if the links do not work, message Chris Robinson and he will delete the videos C4: Questions click on the questions icons, do they work? are they appropriate for the Step topic in which they are located Step 1, the icons should be green Step 2, blue Step 3, purple depending on the stage of the question, the pop out may say different things all that is necessary is that when you click on the icon, a new window within the current one should appear C5: References did you use any of the references? check off the boxes of the references you used if you used an article, paste the article in the comment box Topic Format Content template can be found here: https://upload.medbullets.com/topicview?id=21 Use of commas we use the oxford comma when listing items for example x, y, z should be x, y, and z Chris, Moises should be Chris and Moises Human genes human genes symbols are all uppercase and italicized protein symbols are all uppercase but not italiziced Diseases named after people we are dropping the 's Parkinson disease Alport syndrome Huntington disease Chart Backbones NOTE: Make sure to only copy the charts from View Topic Mode Step 1 Title Should Be in Title Case, Bold, and Center Aligned (Background Should Be #d4f2cd ) - For More Info Subcategory (Background Should Be #f4f4f4) Columns Are Center Aligned Bolded and Title Case First column is sentence case, aligned to the left, and vertically centered with no bullets Make sure the bullets are the same size A problem arises when you go from a lower priority bullet to a higher priority bullet Make sure the spacing is correct between sentences The alignment for the columns below the titles above and to the right of the first column should be left aligned vertically centered Step 2 Title Should Be in Title Case, Bold, and Center Aligned (Background Should Be #ccccff ) Subcategory (Background Should Be #f4f4f4) Columns Are Center Aligned Bolded and Title Case First column is sentence case, aligned to the left, and vertically centered with no bullets Make sure the bullets are the same size A problem arises when you go from a lower priority bullet to a higher priority bullet Make sure the spacing is correct between sentences The alignment for the columns below the titles above and to the right of the first column should be left aligned vertically centered Updating Topic Checklist (Please Add Comments and Type Y or N) Copy/paste this version into your comment box when reviewing questions C1: Snapshot: Y/N C2: Content/grammar: Y/N C3: Images/Videos: Y/N C4: Questions: Y/N C5: References: Y/N Illustration Creation Guidelines Pointing to an item in an illustration use a 1 pt solid line to point from the word to the item that you are illustrating make sure that the lines ends within the item the line should cross the minimum number of structures possible Capitalization titles: Should Be In Title Case (I Illustrated It Here) bullets or bullet style items: Use sentence case if you are going to use bullets or a list of items that is a new line; capitalize only the first word How to save your illlustration send to personnel@medbullets.com save the file in the following format date initials Step# specialty drawing name example: 01212017CRStep1MicroGram-NegativeBacteria send original adobe illustrator (.ai) file along with illustration Work in Progress Responding to Member Comments Click on the Member Comment's tab on your Author Dashboard Select a question or comment you would like to post a response; only select one at at time Save a comment only visible to authors by saying "replying to comment" you will have 30 minutes to respond to the comment it is best not to claim the comment if you will not respond within 30 minutes, otherwise another author can claim the comment 30 minutes after the time stamp for topics, you must go to edit topic mode and save a comment then return to the view topic mode and respond for questions, you must click on "Post to Members" and save a comment To receive the $7 for the comment, you will need to post 4+ sentences of solid information and an optional reference (only do so when relevant) respond to the comment thoroughly (~5 sentences is a great length, but don't add fluff just to meet that length. Some require more or less sentences) If you do not understand a member's question, feel free to ask the member to clarify. You will not be credited for that comment, but you will receive an email (if you click to be informed on the topic) when the member posts a comment back and if you can respond within a few hours, you will be credited for your response If a response does not meet the 4+ sentences and is not solid, a message will be sent to you the first several times to help you improve your response The Little Things: Do not respond to questions from other Qbanks if a member posts a comment that you feel is from another Qbank, a test prep company or its materials, or a school exam, please do not answer it, send Chris Robinson a message from that topic or question start off your comment with "Our policy here on Medbullets is to only answer medically related questions that are not associated with any other testing entity" you can provide some high yield information regarding the topic that they and our other members can use to answer a possible question regarding that topic on the USMLE you don't want to answer their question directly but provide them information to use to answer it themselves if they choose if they repeatedly, post similar comments, please contact Chris Robinson and he will reach out to the member Mistakes do happen if you post a comment in response to a member regarding one of the multiple choice questions, simply click on the blue words "Make Private" and repost your comment unfortunately, the member will receive an email, but the rest of the members will only see your corrected comment if you post a comment on a topic, you can do the same as above but you must go into the Edit Topic mode to make it private then go back into View Topic mode to repost a comment a similar thing happens above regarding the email note, when you make a comment private, it will remove the credit from the ownership dashboard, but when you post again you will receive the credit Responding to just statements by members unless the a general statement posted by a member is correct, we will not post a response if a statement is incorrect or you think the information should be added to the topic/question, you can add it to the topic/question only if it makes the topic/question better never feel that you had to take the side of the member if you feel the comment is not helpful or the information is not useful - just be respectful and polite Numbers format use numerals for ALL numbers 1-year-old female 2 cm in diameter respirations are 25/min Don't forget to use "and" in a list of 2 or more items Chris and Derek Chris, Don, and Derek If a member address a specific author, ANY author can still respond make sure to read any previous comments so that you are respond appropriately Do not supersede another author by posting a corrected comment we do make mistakes and if you find another author has accidentally made a mistake in the post, please make the comment "Private" then contact the author letting the author know what happened and ask if the original posting author can repost with the correct information Helpful Tips If the comment is simply to make a quick change to a topic or question, you should quickly make the change and post a "High Yield" comment regarding the topic or topic of the question Comments that do not adequately address the member's comment and duplicate comments will not be credited (you can always edit your comment by making it private then repost again) our goal is to post high yield information that addresses our member's comments and the comments are extensions of our topics for all members to see Note: if a member has messaged you privately with any questions, please let Chris Robinson know and ask them to post their comment on the appropriate topic and question DO NOT ANSWER THEIR QUESTION PRIVATELY as you will not be credited Examples of responses: for a very thorough response to a comment, see the comment no article was posted but he fully addressed the comment not all comments have to be this length but the idea is to adequately address the member's comment for an example of making a quick change to the topic (not updating the topic) such as in the case of correcting a typo or adding a line in and posting a high yield comment, see the comment Please do respond to any comments that you want to respond by clicking on the Member Comments tab in your Author Dashboard Symbols to use (Just copy and paste in View Topic Mode NOT Edit Mode): Degree: ° mm^3: mm3 micro: μ Oxygen: O2 Water: H 2O Calcium divalent cation: Ca2+ Sodium ion: Na+ Potssium ion: K+ Up arrow: ↑ Down arrow: ↓ Forward arrow: → Beta: β Alpha: α Gamma: γ Greater than or equal to: ≥ Always under construction Requesting a Topic to Be Created When you write a question and it does NOT have a topic, DO NOT link it to a topic in a different Step than you are writing the question for example, if you are writing a Step 2 question, do not link it to a Step 1 topic what you should do is request a topic to be created How to request a topic message Chris Robinson from your question and copy, paste, and fill in the following checklist: URL of the question: What topic do you want created and describe it: Does a topic exist in the other Step, please paste in the URL: Between what two topics do you want the new topic to be placed: We will try to create the topic for you as soon as we can You will be messaged once the topic is created and you should then link your question Payroll Policy Being on the MB team means creating high quality questions and topics and doing so in a consistent and methodical manner Our budget on the ownershipdashboard is ~$8-10,000/month some activity does happen off the ownershipdashboard which includes illustrations, creation of new topics, editorial hours but this is not always included in the budget above we will have our $1,000 threshold (some months will be $1,250) for all activity if you hit the $1,000 threshold, contact Chris at personnel@medbullets.com he will review your within 24 hours and based on the quality will raise it in increments of $250-$500 all authors/editors are available to have their threshhold raised for that month and will be reset to $1,000 the following month before you send Chris an email to raise your threshold for that month, make sure all EAs and issues have been addressed on your account There is a hard ceiling of $1,000 for creating questions/topics each month, $750 for responding to comments, and $500 for reviewing questions ($1,000 if you are only a reviewer). these limits will only be raised if we are in need of questions or topics for that month The maximum threshhold for any author for any month is $2,000 including on and off the ownershipdashboard earnings Note, if activity occurs very rapidly in the beginning of the month, we may have to curtail activity accordingly as the month progresses