By Jacob Scholl
Rarely does a topic come along that is relevant to literally everyone. For me, it happened in my first year in graduate school: when I finally learned how to learn.
Everyone learns. Whether the goal is memorizing a new phone number or studying to pass a standardized exam… life demands comprehension.
To be clear, I didn’t consider myself a poor learner. I’m proud of my academic achievements and I’m excited to continue learning throughout my career in medicine. However, I was surprised to find that many of my study habits were entirely improvised.
Very few students explore the evidence behind learning. I certainly didn’t. Luckily, the first class session of an elective course, ‘Introduction to Medical Education,’ introduced me to my new best friends, The Six Strategies for Effective Learning.
#1 Spaced Practice, aka: Don’t Cram!
As much as I would try to study daily in college, I often found myself cramming the night before an exam. I knew this wasn’t the best way to study but I never knew why.
Spaced Practice is a technique in which you study consistently and review often — to keep that lecture from a few months ago safe in your long-term memory. This learning strategy calls for same-day review of material, followed by spaced recall in the weeks and months that follow. Evidence suggests that five hours of study spaced over an entire week is more effective than five hours in one sitting. After incorporating Spaced Practice as a study technique, I experienced an increase in my knowledge retention, and a decrease in my stress.
#2 Retrieval Practice, aka: Practice Remembering!
Previously, I would ‘study’ by mindlessly scrolling through lecture slides as if they were an Instagram feed. It looks like studying. It feels like studying. But I had a difficult time reproducing lecture content on exam day.
It turns out that the best way to solidify knowledge is to practice remembering, a concept beautifully coined Retrieval Practice. When I switched from being a slide zombie to flashcards, making my own tests, and writing out key concepts on a blank piece of paper, my test scores jumped an entire letter grade. There are many ways to implement Retrieval Practice, but the most important strategy for me is to recall course material in various ways, and check that I did so accurately.
#3 Interleaving, aka: Shuffle the Deck!
Here was my old study schedule: anatomy, dermatology, neurology, pharmacology. The next day would be (shockingly): anatomy, dermatology, neurology, pharmacology. I would repeat this over and over and over again. This type of repetitive ‘same time, same place’ block scheduling has long been a mainstay of my studying. Then, I learned about Interleaving.
Interleaving calls for varied study patterns that provoke a more robust understanding of related concepts. For example, if I was trying to master subjects A, B, and C, I would be best served studying first in an A-B-C pattern, and then the following session studying B-A-C, and then C-B-A, and so forth. While putting my brain on ‘shuffle’ felt much more difficult, it has been shown to strengthen connections between topics and ultimately promote adaptive expertise.
Interleaving positively impacts my experience of synchronous teaching sessions, as well. Previously, I bristled when a lecturer would pivot unexpectedly to another subject; but now, I appreciate the connections they illustrate for me.
#4 Elaboration, aka: Use a Concept Map!
Recently, I was trying to memorize which physical exam techniques are used to identify specific knee injuries. My strategy was to look at the names of the techniques and match them to the names of the injuries, like those matching tests we took in elementary school. While I was absorbing some name-matching via rote memorization, it was highly unsatisfying, and I was sure I’d forget everything after the exam.
Elaboration builds connections of key concepts. Deeply explore topics and let your brain take you down all of the paths labeled “why.” So, instead of name-matching, I started researching the physical exam techniques further. I watched videos of physical therapy experts performing the tests and explaining why they worked. I began identifying similarities between the knee exams and other physical exam techniques. I started weaving undergraduate physics concepts with last year’s clinical anatomy. And then the discomfort and futility of rote memorization dissipated, replaced by a warm curiosity and confidence.
#5 Dual Coding, aka: Doodle!
I hate textbooks. Show me a dense block of text and then show me the door. Obviously, I’m capable of reading. Rather, it’s that I know I am learning in the least efficient, most painful manner possible. I’ve had a natural avulsion to dense text for as long as I can remember, but I would still force myself to reread textbooks over and over. It felt insufferable. Then I found Dual Coding.
Dual Coding urges learners to combine spoken or written words with visuals, and to invent new ways to use sensory expression to map information. The more creative the better. Here is how I apply Dual Coding for concepts presented primarily with text: I skim the text to find the important concepts… then I watch as many videos as possible about those concepts… then I illustrate the concepts using fun art tools… then I go back and solidify my understanding by double-checking the textbook. It works astronomically better than ramming my brain against a book. I’ll never go back to wasting hours on a black and white tome.
#6 Concrete Examples, aka: Tell Stories!
This may sound strange, but nearly every new disease I learn about gets matched to someone I know who either has the disease or reminds me of the disease process. Why is that? Why does my own knee quiver when I learn about ACL injuries? Why do the names of my former teammates register when I learn about varus and valgus stress?
The Learning Scientists say it’s because the human brain loves Concrete Examples. We love stories. Concrete Examples, such as clinical cases, personify content and promote memory. I use this strategy whenever possible. I imagine myself in the clinical case and I pretend that I’m responsible for creating the treatment plan. Through the story of the patient, I better understand the importance of key findings and I take responsibility for my fictional patients. Concrete Examples make a world of difference for me.
I hope you found my interpretation of The Six Strategies for Effective Learning as transformative as I have. Thank you for reading.
About the author:
Jacob School is a student in the Master of Science in Physician Assistant Studies program at Stanford School of Medicine.
Edited by Michael A. Gisondi, MD, Twitter: @MikeGisondi
Image credit: Pexels
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