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How to Learn
 
 

Overview

Studying is a key part of the medical school experience - whether it is alone or in a group. You’ll be spending plenty of long days or nights in the books, on your laptop or with a plethora of study tools.
The truth about study is that it adheres to the 80:20 principle: 80% of your learning will happen with 20% of your effort. This can mean that you may be hitting your head against a wall for a long time! Fortunately, there are ways to optimise your study time to get the most out of it.

Plan Your Study

It can be difficult and demoralising to study effectively without knowing what you’re working toward, or what timeline you’re on. When starting a new year or new block, identify your study goal (e.g. end of term exams or the USLME part 1) and consider creating a study plan that works toward this. Planning in this way will ensure that you’re steadily working toward your end goal, rather than floating along to begin with and cramming before exams.
  • Set SMART goals while studying:
  • Specific - make sure that your study goals are clear and well defined
  • Measurable - consider how much and how you will know you when you have achieved what you set out, so that you can measure success
  • Achievable - be realistic - avoid too little, not too much
  • Relevant - choosing what makes sense to study at this time. How will it benefit you for this study session or sessions?
  • Time-bound - realistic timing and a target date / time for completion
Before you start each study session, try to take some time to plan the session. Decide on your goals, what tools you’ll use and how long you plan to study for. Are you studying cardiology? Will you be watching recorded lectures and making notes, or reviewing your flashcards with last week’s content?
Use chunking to avoid feeling overwhelmed at the amount of information that you have to learn - break your learning goals into manageable chunks and focus on each chunk one at a time. For example, focus on neuroanatomy before moving onto neurophysiology.

Optimise Your Study Environment

It is important to set up a clearly designated space for study, and make sure that you have all of the materials you need close at hand. Everyone learns optimally in a different way, and over time you’ll come to find what works best for you in terms of study environment.
  • Timing

  • Are you a morning studier, waking up and getting an early start on learning, or do you learn best at night? You will find a rhythm to when you retain information best as you continue to study.
  • Light

  • Do you prefer a well-lit or dimly lit environment for studying? Natural light is best, but a well-lit environment is a good alternative. Try to avoid very darkly lit rooms as this can result in eye strain and headaches.
Interestingly, a study on light temperature showed that students were more creative under warm light (3000 K) and concentrated better under cool light (6000 K).
  • Sound

  • Do you like to study in a loud or quiet environment? Some people study best in a quiet environment, and would benefit from earplugs or noise cancelling headphones when in noisy environments. Others prefer a louder environment for study. There have been studies to suggest that background noise like cafe background noise, white noise and rain can improve concentration and in particular improve creative thinking. Try to avoid music with too many words while studying, as this can negatively affect concentration. There are several good channels on YouTube that have good chilled out music to study to, which avoid having too many lyrics or too much variation.
  • Location

  • Do you prefer to study at home, or elsewhere? Some learn best at home, which is a familiar environment. Others will study at a library or other public space in order to avoid distractions and be closer to the resources they need.
  • Company

  • Do you study better by yourself, or in a group? Often you will find yourself reading, listening, note taking or self-testing alone; you may find that studying in a small group allows you to bounce ideas off others, calibrate to an expected standard, or get motivation to study.
  • Avoid Distractions

  • Remove distractions such as your phone, and avoid social media. If you’re in an area where you could be distracted, inform others that you are studying and need some space and some quiet. 

Understand the Big Picture

Before delving deep into the details of a topic, ensure that you understand the overall structure and key topics first. Once you comprehend the underlying ‘architecture’ of a topic it will be much quicker to fit in the details around this and understand how everything fits together.
Good ways of quickly gauging the overall structure are by reading the objectives at the start of lecture slides, or checking the table of contents of a textbook.

Learn in Short Bursts

Traditionally, the approach to study has been to study for long hours and attempt to absorb as much information as possible during a set period of time - this is known as a focused study mode.
There has been a switch in thinking over the past decade, and it is now felt that taking breaks is just as important as focused study. These breaks, known as diffuse mode, have important effects on comprehension and retention of information by allowing the brain (in neutral gear) to form connections between pieces of information. As a result, new insights can appear that may not have otherwise materialised.
The best way to do this is the pomodoro technique. Set a timer for 25 minutes of focused study, and then follow this with a 5-minute break with a reward. This reward can be anything - a song, a video, a snack, or mindfulness. This cycle can then be repeated for as long as you need to study for.

Practice Recall

Once you’ve finished reading about a topic or taking notes, try to recall the key points that you’ve learned - even just forcing yourself to remember can help to cement a concept in your mind.
Use the Feynman technique - try to explain the topic to a twelve year-old child in your head. Use the simplest possible language, with metaphors and analogies as illustration. This will force you to focus on the key aspects of the concept. If you’re not able to explain something, then take that as a trigger to go back to the source material and go over that part again.
Alternatively, try to imagine that you are explaining a disease to a patient who has just been diagnosed with it.
Such recall slows down the rate of forgetting, so that you’ll be more likely to remember it next time.

Test Yourself

Unfortunately, it’s not enough to read information once and then retain it forever. It’s also not enough to read the same piece of information over and over again! 
Long term retention of information can be achieved by learning something and then actively recalling it. In a study of students learning foreign language vocabulary, repeated study had no effect on delayed recall, while repeated testing had a significant positive effect.
There are many ways to test yourself. 
  • Use Question Banks

  • There are many question banks available for a wide variety of medical topics - these can be online, shared between peers, or even in the back of textbooks. Try to find a question bank that helps you work toward a specific goal that you have - such as the USMLE.
  • Create Your Own Questions / Flashcards

  • Flashcards are an incredible way of promoting recall. They provide the ability to test yourself on key concepts, and good flashcard platforms use the concept of spacing repetition to ensure that you’re presented with cards right when you’re about to forget them - using the Ebbinghaus forgetting curve.
Creating your own questions can also help with recall.
Consider using the MedSchool MyQuizzes and Flashcards sections to create your own questions / flashcards and start testing yourself.

Join a Study Group

Your university may create a study group for you. If not, then consider creating your own study group. This can be to study for a specific assessment, practice practical skills or to generally learn together.
The benefits of study groups are many - if you’re having issues with motivation then a group can hold you to task and push you to keep up with your learning schedule.
  • A few tips in forming a study group are:
  • Keep the group small - aim for three to five members.
  • Find others with similar goals and expectations to you.
  • Avoid being in a study group with close friends, as this can prove to be a distraction.
  • Try to include others with different skill sets so that there are different types of contribution to the group.
  • Have a shared study schedule that you agree on, and stick to the schedule.
  • Study for one to two hours at a time - too short and you won’t accomplish much, too long and you’ll start getting less productive.

Teach Others

Explaining a concept to others significantly improves your understanding of the topic. In fact, this benefit occurs even when you simply expect to teach a concept. In a Washington University study, 56 students were asked to learn written material; half were told that they would then take a test on the topic and half were told that they would go on to teach the topic to others. Those who believed that they were going to teach demonstrated improved recall compared to the other group.
Teaching can occur in many different ways. Universities often have problem-based or team-based learning sessions where students have the opportunity to teach topics of interest to their colleagues. Medical schools also often have peer tutoring systems where higher year medical students teach early year students. Hospital teams often have journal clubs where students present recent papers. 
More simply, consider using the Feynman technique and pretend to teach a topic that you’ve just learned to a twelve year old, in the simplest language possible.
No matter the opportunities that are available, try to find ways to teach others as it will benefit you as well.
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References

Angwin AJ, Wilson WJ, Arnott WL, Signorini A, Barry RJ, Copland DA. White noise enhances new-word learning in healthy adults. Scientific reports. 2017 Oct 12;7(1):1-6.
Baddeley AD, Longman DJ. The influence of length and frequency of training session on the rate of learning to type. Ergonomics. 1978 Aug 1;21(8):627-35.
Bönstrup M, Iturrate I, Thompson R, Cruciani G, Censor N, Cohen LG. A rapid form of offline consolidation in skill learning. Current Biology. 2019 Apr 22;29(8):1346-51.
Karpicke JD, Roediger HL. The critical importance of retrieval for learning. science. 2008 Feb 15;319(5865):966-8.
Mehta R, Zhu R, Cheema A. Is noise always bad? Exploring the effects of ambient noise on creative cognition. Journal of Consumer Research. 2012 Dec 1;39(4):784-99. 
Nestojko JF, Bui DC, Kornell N, Bjork EL. Expecting to teach enhances learning and organization of knowledge in free recall of text passages. Memory & cognition. 2014 Oct;42(7):1038-48.
Weitbrecht WU, Bärwolff H, Lischke A, Jünger S. Effect of Light Color Temperature on Human Concentration and Creativity. Fortschritte der Neurologie-psychiatrie. 2015 Jun 22;83(6):344-8. 
 
 

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