Kuldeep is a 29 yo medical student who has been studying daily but can’t seem to keep up with the content. His friends seem to be scoring higher than him on tests. How can Kuldeep add some new habits and learn how to study more effectively?
When it comes to studying, we are often poor judges of when we are learning well and when we are not. Evidence shows that information sticks better when the mind has to work. Working smarter, not only harder, leads to the most success.
A strategy that many students use to study is re-reading, which gives us the feeling of fluency, which may be mistaken as mastery. Retrieval practice is more effective than re-reading. Retrieval practice is the process of pulling information out of brains, rather than simply recognizing, and keeps us from forgetting.1 Examples include self quizzes or flash cards. This effect is magnified when combined with spaced repetition, where serial exposures are distanced based on knowledge. Apps (like Anki, Brainscape, and CanadiEM flashcards) can organize topic frequency based on mastery; less familiar topics can appear more often.
Interleaving, the act of mixing together different topics, helps retain information and mimics the real world (think of patients in the emergency department or questions on an exam). While it may seem easier to study one topic at a time, interleaving forces our brain to make new connections. More pathways equals easier recall.
A common myth is that making errors is detrimental to your learning. However, problem-solving creates longer retention as long as corrective feedback is present. It can be frustrating given a case with no answers for example, but the process of you working through and finding out the answer is where the real learning happens. Elaboration can also be used to teach a friend the content.
Learning should always be effortful, which requires self-discipline, perseverance and grit. You should also have a growth mindset; your knowledge is not fixed, neither are your study habits!
Think of how you studied for your last exam. How could you integrate these techniques to boost your study habits?
After learning about effective study strategies, Kuldeep builds a flashcard deck from information during teaching sessions. Before and after each shift he does 5 cards, noting which ones he struggles with and devotes time to dedicated review of those topics (retrieval practice and spacing). From each patient he sees, he writes down one learning objective that he frames as a quiz question (elaboration). Each week, he completes this quiz (interleaving). He and a friend regularly teach each other different topics. By the time the exam rolls around, he’s mastered content, has a clear sense of areas he needs to review and is ready for his next rotation! He mixes in his flashcards from previous blocks so that he can continue to keep up his knowledge for his licensing exams at the end of the year and has become a pro at knowing how to study effectively!
To continue your journey towards next-level learning, we recommend checking out the excellent review of effective learning strategies by EM Cases, found here.
This post was copyedited by Joe Boyle
- 1.Brown PC. Make It Stick. Published online April 14, 2014. doi:10.4159/9780674419377
Reviewing with the Staff
I didn’t learn how to study till AFTER I had finished all my major examinations. It wasn’t until I was doing my Clinician Educator diploma through the Royal College that I realized how many hours I had wasted on ineffective study techniques. How many pages had I painted yellow, re-read till I had them memorized or lectures had I listened to at 1.25 speed (while also playing fortnite)?
Recognizing how to study in an evidenced based manner has been a game changer, and changed the way I engage with students. This article is to help encourage both learners and faculty to reflect on their teaching methods, to push people to go past ‘learning styles’ and to encourage honest and critical reflection of how we can truly be lifelong learners.
Studying for an exam is like prepping for a big game. Strength connections, train your muscles and force yourself to think critically about the information. Retrieval practice and spacing helps keep the information fresh in a practical manner by forcing you to recall it rather than just recognize. Interleaving layers different topics on top of each other (like how patients present to the ED). Elaboration ensures you understand it and can explain it. When you can, teach the information to someone else!