Study tips for medical students

Retrieval and spaced practice

Successful performance in exams relies on being able to retrieve information from your long term memory. Accessing your long term memory is like rediscovering a path—if you have been down it many times before, the neurological connections are stronger and information is easier to remember.

Retrieval practice helps to build these connections, giving you practice at remembering. The three main ways to build retrieval practice into your study are:

• Spacing your revision of topics

• Practising recall before you revisit your notes

• Using practice questions and preparing flashcards to test your recall.

People tend to study a topic in one block before moving on to the next topic, and this is often how students revise. However, spacing out the revision of a large topic over several weeks can benefit your performance and ability to recall information in the long term.6789 This is because you have to start each session by retrieving knowledge from the last one. To use this strategy effectively, it is important to plan a revision schedule so you don’t run out of time.

Before starting to revise a topic, try to recall as much as you can about it. Only read through your notes and any course material after you have attempted to recall as much as you can. Having to actively think about what you already know can help to identify gaps in your knowledge or understanding, which indicate where you need to focus your revision.

Preparing your own flashcards from memory and then using them to revise is another good method of retrieval practice. You can also use practice questions, papers, or quizzes, checking that your answers are correct. This is also an effective way to incorporate retrieval practice into your revision.1011

Elaboration, concrete examples, and dual coding

Elaboration involves taking a subject or concept and describing it in as much detail as you can. Asking questions such as “why?” and “how?” helps you to draw out detailed knowledge.

Coming up with concrete examples to demonstrate abstract ideas will also help to make information easier to recall.12 Examples help with the understanding of concepts, rather than factual recall.

Creating concept maps (fig 1) can be a useful way to combine elaboration and concrete examples, as well as link ideas. This helps to develop clinical reasoning and problem solving skills.1314

Fig 1

Potential causes and types of seizure, showing how they are related to each other

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Presenting words in a visual format, such as in a concept map, also enhances learning14 through a strategy called dual coding, where you present the same information in two formats —visual and verbal. This strategy is particularly useful when learning medical topics such as anatomy, which require visual diagrams or illustrations as well as words.14

Mixing things up

Interleaving —also known as “mixing things up”—can be another powerful learning strategy to aid recall of related but separate topics.

A common approach many students take is to revise topics by subject, because this is usually the way they are taught or presented in textbooks. For example, within a cardiology module a student might revise heart failure, followed by ischaemic heart disease. However, with interleaving, your revision strategy would entail switching between study of different subject areas that are related in some way. You could revise different conditions that cause breathlessness: heart failure, asthma, and pulmonary embolism. This makes it easier to identify different, but similar, conditions.

Studies have found that interleaving aids long term recall and discrimination between concepts.15 In one study designed to teach students electrocardiogram interpretation, participants in the group who practised interpreting a mixed series of electrocardiograms scored higher than the group who practised interpreting electrocardiograms that showed similar abnormalities.16

Interleaving topics can feel awkward compared with studying one topic thoroughly before moving on to another. However, studies have shown that interleaving is better than other techniques in helping people retain knowledge in the long term.46151617

Effective learning requires effort and organisation

Educational studies show the advantages that taking a strategic, organised approach to learning has over cramming facts in a short space of time.3 Brown and colleagues, in their book Make It Stick: the science of successful learning, write: “We are poor judges of when we are learning well and when we’re not. When the going is harder and slower and it doesn’t feel productive, we are drawn to strategies that feel more fruitful, unaware that the gains from these strategies are often temporary.”6

The strategies described in this article might seem challenging, but diversifying your learning strategies and spreading out your revision will benefit you not only in your exams but also in your future role as a doctor and lifelong learner.