Things to ponder when you should be studying for exams, part 1

[fossildoc]

When I'm not under exam pressure, I study a lot. When I'm under exam pressure, I digress a lot. Somebody out there knows the psychodynamics of this; please respond with the explanation. It may be related to the phenomenon of increased movie theater attendance during economic depressions.

For the similarly afflicted, this post is the first of a series of irrelevant philosophical conundrums to ponder when you should be studying for exams.

Here is the issue du jour, including corollaries: if you take an exam and give an answer which differs from what's in your textbook, on the teacher's PowerPoint slides, and lecture notes, but which is nevertheless correct based on external evidence (i.e., the aforementioned sources are wrong), should you be given credit for your answer? If you are not a marginal student, how far should you go in fighting for the two points? What should be done with teachers who are so emotionally attached to their false beliefs that they can never admit being wrong, especially when correction comes from a student? Should such teachers be allowed to continue their employment?

The relevant psychodynamics is called "cognitive dissonance", a heavily studied new discovery in the seventies, now subsumed in the general rubric of psychology.

Just so we all know (yawn) what I'm talking about, here's a sample question from Biochemistry:

A purified protein sample is subject to stepwise degradation by Edman's reagent and found to contain the sequence his-gly-arg-pro. It is then treated with the serine protease trypsin. Where will trypsin cleave this protein?
a) on the C-terminus side of histidine
b) on the C-terminus side of glycine
c) on the C-terminus side of arginine
d) trypsin will not cleave this protein

The answer, according to the fourth edition of Lippincott's Biochemistry, Chapter 2, is "c". But that's wrong, because trypsin will not do its thing if arginine (or also its other target, lysine) is followed by a proline residue. The real answer, then, is "d".

Students who answer "c" should get credit because they read the book, the PowerPoints, and the handouts, all of which are wrong. The nerd who researched everything online and discovered all the omissions in the book -- which are needed to keep its size down -- is in possession of the real Truth. Should s/he be given credit? What if the teacher doesn't budge because s/he will "lose face"?

If you want an example of something from a book which is actually wrong, and not merely an omission, look in Goljan's Rapid Review Pathology. It says Charcot-Bouchard aneurysms are macroaneurysms, but that's wrong. They're microaneurysms. Teachers who are cult followers of Goljan will have a difficult time with this. They probably all belong to the Flat Earth Society.

This post is not related to any incident at school ;), but the issue has come up occasionally in other contexts.

Now put down those books you're studying for the second block exam, and respond.

[Kreius]

That's how I fail most of my tests.
It's all about mainstreaming information, we have a basic standard for information, which we'll assume that the lecturer explains. This creates a formal domain of 'knowledge', which we'll conveniently call FSW. The axioms for all deduction in FSW are based on the lecturer, which may or may not be wrong; but the important thing to denote here is that the lecturer decides the axioms and rules of FSW. In other words, whatever your lecturer is explaining to you, it doesn't have to necessarily have to relate to anything real; this is only a pompous rule we, people who trust scientists, have devised to avoid these kinds of situations.
In order to get a good grade, the most ecumenical solution would just be to write down the right answer, then approach the test-giver after the test. Probabilistically speaking, this is the best way to deal with it, specifically if you're taking SAT type tests that you can't go back and force credit for answering the 'wrong' answer to the specific question via correction of it; which would've been the action with most moxie (i.e. put down the real right answer and approach the test-giver, there's no guarantee).
That philosophical enough for yeh?

[fossildoc]

...The axioms for all deduction in FSW are based on the lecturer, which may or may not be wrong; but the important thing to denote here is that the lecturer decides the axioms and rules of FSW. In other words, whatever your lecturer is explaining to you, it doesn't have to necessarily have to relate to anything real; this is only a pompous rule we, people who trust scientists, have devised to avoid these kinds of situations.
In order to get a good grade, the most ecumenical solution would just be to write down the right answer...

Thank you for responding.

Yes, and what you say I've been trying to explain to the teachers here for a long time, and they just don't "get it". I see you're a newbie, and I'll assume you're a new student, so let me 'splain how things work here. There is a strong tradition, promulgated by teachers and supported by most students, of knowing what you 'need to know' for Step 1, to the exclusion of everything else. There is actually some merit to this on the theory that time spent outside of Step 1 sarifices time which should be spent on testable material, and therefore jeopardizes one's prospects of passing. This is a complex issue, but whatever your position, such a tradition invokes the conflicts which are the subject of this thread.

Here's how it works: upon starting class, after you recover from the initial humiliation of having to wear a uniform, you will be infuriated when the teacher announces that the ten pound expensive textbook you've just bought -- which is little more than a marketing scheme on the school web site -- is to be discarded in favor of dime-thin 'review' books like BRS, Ridiculously Simple, Road Map, Clinical Vignettes, Rapid Review, and High Yield. Why? Because they answer questions purloined from previous Step 1 exams. They contain virtually no explanation of anything, and never mind that you'll never achieve the flexibility to treat a patient who has the audacity to present with symptoms not exactly as described in those Classic Comic versions of medicine.

In condensing a ten pound book to a three ounce paperback, information is simplified and summarized, which are euphemisms for 'wrong'. If you, the astute and conscientious student hoping to avoid killing someone by following the precepts in these books, should discover a simplification so egregious that you simply must speak out in class, you will be subjected to a triple whammy. First, the teacher -- almost always an Eastern culture person in whose native country challenges to authority are simply not tolerated in the classroom, but that is a topic of a forthcoming post so I'll leave it there --will give you the silent stare of insolence for a few seconds -- "looking daggers", as Shakespeare would say -- followed by a soliloquoy on the foolishness of one so ignorant as lil' ol' you questioning a textbook icon.

Next, your classmates -- the barroom thugs whose parents gave them the choice of going to medical school or getting out of the house to be on their own -- will hound you mercilessly for being a troublemaker and setting up an untenable situation in which the teacher "may ask us" on an exam a question related to your objection, for which the 'correct' answer is now in doubt.

Third, you may very well get such a question and get it wrong, with no appeal because the teacher, after all, is the teacher, and will not lose face in spite of overwhelming evidence in your favor.

It's time for a real example. In Lippincott's Pharmacology there is an almost parenthetical statement that metaproterenol is not really a catecholamine although it is traditionally classified as such because its structure and pharmacodynamics are similar to real catecholamines.

That prompted a little research. In order for a compound to be considered a catecholamine, it must have a catechol residue and an amine group. The stuff in between distinguishes one catecholamine from another. Catechol is a benzene ring with two hydroxyl groups in the 'ortho' position, i.e., on adjacent carbons. All the real catecholamines like epinephrine, norepinephrine, and dopamine have this structure.

Metaproterenol, however, has two hydroxyl groups in the 'meta' position, i.e., with one intervening carbon, hence the 'meta' in metaproterenol. A benzene ring with two hydroxyls in the meta position is called resorcinol -- not catechol -- hence metaproterenol is a resorcinolamine, not a catecholamine. Lippincott was right, for a change.

When I mentioned this in class in another context, the teacher, who is loaded with credentials and is otherwise very smart, vigorously denied my allegation. He was ready to show me one textbook after another that listed metaproterenol as a catecholamine, and referred me to an ultimate source -- all teachers here worship at least one author -- which was a two-hundred fifty dollar book and beyond my means to buy for examination. The fact that all his books were wrong could have easily been verified by some online research into the chemical structure of metaproterenol, but the teacher apparently was of the same mindset as the theologians of a dark era in science when a great debate arose regarding the number of teeth in a horse's mouth; the theologians insisted the issue could be resolved by theological speculation in spite of compelling evidence proferred by the anatomists, such as they were. In other words, appeal to authority took precedence over observable data.

As a practical matter, it boils down to the following multiple-guess question on a block exam:
Which class of chemicals does metaproterenol belong to?
a) catecholamines
b) resorcinolamines
c) hydroxyquinoneamines
d) phenolamines

Today's dilemma: to answer 'a' or 'b'?

The appeal to authority rather than hard science permeates all the Caribbean medical schools, from what my spies in those schools tell me, and I wouldn't be surprised if it perseveres in U.S. schools as well. We all know that medicine is dominated by Napolean-complexed holier-than-thou egotists who would never allow correction by a student, or even by each other (yes, it is commonplace here for teachers to make derogatory comments in class about other teachers). For you, the personal crisis to be resolved is how you will deal with these issues in class, as they will surface many times in every subject in every semester.

Good luck in your studies.