Let me start by saying I go to mid size 4 year college with a class size of about 35. My school includes pathophysiology and pharmacology within the med surg class content.This class was 6 credits and had 80 clinical hours with additional ATI,case studies,papers and reflection journals. This class determines if you are going to graduate on time or fail out of the program. Each test was 18.75%, totaling 75% of my final grade. This class recently got a reboot and they redid parts of the curriculum. For instance the tests in the past were open book, now they're not. I know, they shouldn't been open book in the first place, but I digress. Also the text book is new and they now do not go over the PowerPoints in class as the main lecture. So big changes. I went into taking this class with the thought that an A was impossible and I would be happy with a B. I still would have to work really hard for a B. So buckled down and started making notes. How I did my notes/ How I studied Before class I printed out the power point and did notes on the powerpoints, and underlinig the points that they made, or writing more information. Then I read the text book, ONLY reading the content that was covered in the PP. There was no way I was gonna read everything in that text. This was my way of filtering info. When I read the text book, I was taking more notes on that PP print out. Eventually it was covered information pertinent for the test. I made lists of things needed for procedures or treatments. Lists became my best friend for listing the need to know information I circled my Priorities in red. This could be major adverse effects for drugs, priority teachings, High alert lab values, etc. After taking notes, I never opened my text book again. I only studies those notes.The notes process would take a couple of hours to get truly effective notes, a bit of trail and error. Then before the test I would read the notes, verbalize, try to teach others. Few days before I would do questions out of our study guide book and read all the rationales. Then with my nursing buddy we would go over notes from around 5pm-1030pm, the night before the test. Without her I don't think I could have done as well. One quick glance right before bed and be done. No all nighters!!!! If you don't know it by midnight don't expect to know it at 3 am. Rinse and repeat 4 more times with my lowest test grade of an 80. My school considers an A at 94. So the rest of my grades were 92-98. I got used the type of questions on the test and reformulated my notes to be more oriented towards questions. Definitely a time saver. I am so proud of my self! I hope this information can help other nursing students!