Study Skills for Medical Students Part II Latha

Study Skills for Medical Students: Part II Latha Chandran MD, MPH Associate Dean, Academic Advising Interim Chair. Dept of Pediatrics SUNY at Stony Brook

Features of an MS 1 b Intellectual self doubt b Workload anxiety b Competition vs cooperation b Loss of status! b Difficulty with authoritarian hierarchy b What is the big picture?

Exams b Each course has small exams, quizzes, labs, NBME shelf exams b USMLE Step I before third year b USMLE Step II before graduation b USMLE Step III during residency b Specialty boards after residency b and thereafter………………. . !

Time Management b As a doctor, one needs to do lots of things!- see patients, teach, learn, read, leadership roles, community, exercise, keep friends and family b Give up the idea that you are a student b You are a professional MD in training b Practice using your time WISELY!

Final goal b Pass USMLE Step I II and III b Pace yourself like a long distance runner- practice, practice and practice to build up endurance b Each hour in class- spend two hours outside of class b Take INTERNAL control of your time b Beware Ns and Ps- mngt by crisis!

Memory curve b Imaginary line illustrating the process of remembering and forgetting b Try to create an optimal memory curve- takes practice b Reinforce and expand your learning style dimensions IMMEDIATELY after you learn something new b Use other sensory modalities to remember

Memory curve graphic

Long term memory b Break it down into small pieces b DAILY routine of memory reinforcement b Guard against procrastination

Common causes of academic difficulty b Time Management issues • travel, family, friends, other activities b Material • • • management issues not preparing, no daily reinforcement no CONSCIOUS system of study no “ own notes” b Mental Health issues • depression, LD, ADD

Tips for optimal learning b Create a schedule and follow it b It is your best friend b Skim read/ pre read • generate questions, new terms, charts, graphs, compare/contrast data b Attend lecture b Sit in the front, away from distraction, good lighting

Tips for optimal learning b Analyze data b Memorize- see, hear, say, apply, teach b Mnemonics for physical objects courses ( Funny ones) b Flash cards b Create your OWN flow charts, compare/contrast

Tips for optimal learning b Fit new material into existing info b Practice every day the first week of exposure, use all your senses, and reinforce b You will be able to cut down on study time later for memory brush ups b Add music to your environment if auditory

Schedule construction b When are you most alert? AM, PM? b How much sleep do you need? b Do you need large blocks of uninterrupted time for work? b Do you need a break after 1 -1. 5 hours? b How long a break, what to do then? b When do you study alone? With others?

More tips b Stay with one topic for at least 1. 5 hours b Work with related material b Intersperse difficult subjects with easy ones b Use your highest energy time for the most difficult subject b Volunteer to teach in your group this topic

Learning environment b Music/ food/ pleasant views b Vary sensory use- the more sensory input the more sustained memory b Visual- different colors/ shapes/ sketches, spatial models, slant of writing b Kinetic- use LARGE paper/chalk board

Time Accountability b Time log for sensors • Use a 15 mt block daily calendar • pay attention to your natural rhythms b Time pie- weekly pattern of time use for Ns and Ps- like chunks of time b Using both is IDEAL for both groups b First create a personal time pie

Study sandwich b Put in the difficult subject between two slices of easy ones b Do not fall behind- if you do, catch up on the weekend b Work on the most current material first b To kill time is to murder your chances for success

Taking notes b Ear to hand b One sided; Leave other side of page for text book notes, study group notes-differ color b Leave large margins for LABELING

More on taking notes b If unclear, leave gaps b Fill in spaces/ blanks after talking to another reliable note taker ( use different color, need extra attention) b This is YOUR permanent record b Have a reliable note taking partner each your colleagues

Concept Mapping

Learning syndromes and their management b Reference: Robert Burns, Medical Teacher Vol 28, No 3, 2006, pp 230233 b Nine syndromes b Peculiar predilection to affect early medical students b Management

Six chambered heart syndrome b Excessive analysis of test questions b How many chambers does the heart have? b Are the two auricles chambers? If so six is the right answer b REMEDY: Come up with the answer WITHOUT looking at the options

Slip and Slide syndrome b Studying for the exam that is most imminent to the exclusion of the other concurrent subjects b Very common b Fosters cramming and memorization versus actual learning b REMEDY: Make a contract to study each course’s stuff THE DAY you encounter it- not LATER!

Slip and slide syndrome experiment b University of Arkansas- Three courses running simultaneously b Every third Monday – two exams, and every third Tuesday- one exam b Courses rotated as to which exam came first b Did the students like it?

Slip and slide experiment b Results: • Students did better than predicted in all three courses! b Why? • Never allowed to slip and slide b KEEP UP should be your mantra

Oh Yeah syndrome b. I have seen this before b So I don’t have to pay attention b Depth of understanding required by medical school faculty very different b Oh Yeah turns into Oh No at the time of the exam! b REMEDY: Be aware, pay attention to the detail and the focus

Too many books syndrome b Buying lots of books will NOT translate into learning b REMEDY: Buy only the required course materials and USE them well

Post Genius syndrome b Prior outstanding academic record b Now receiving a C for the first time b Bell shaped distribution for grades b REMEDY: C in a med school course is an acceptable place to start from

Irrelevant material syndrome b “I will never need to use this when I become a physician- so why do I need to learn this? ” b Very common b REMEDY: Crucial to understanding clinical relevance b Also understand principles of life long learning

Alternate Syndrome b. I was on the waiting list, so I can’t be as good as the others b Motivation is key b 27 th alternate admitted as the bottom most rank in the class- ended up graduating first in class in four years b REMEDY: know that the playing ground is level when you start

Old Test Question Syndrome b Variant of the Oh Yeah syndrome b Slight rewording of the stem results in a different answer being correct b Failure to detect the change in the stem results in incorrect answers b Eg: Masson- trichrome stained section of tongue: Identify the organ, identify the blue staining material, identify the germ layer of origin of the surface epithelium b 70% error rate!

MEUL syndrome b Memorize Everything- Understand Little b Very common and very problematic b If you got away with rote memorization in college, you can’t now with soooooo much material! b REMEDY: verify understanding after each major concept

MEUL syndrome treatment b Divide content into “bite sized pieces” b After each bite ( max 30 mts) use the split brain study method, where the other half of the brain poses questions and challenges to your understanding- see if you have TRULY understood what is going on b Delayed ignition study method- in the car, understand it before you turn on the engine • Brief and Intense

General counsel b Get ahead and stay ahead • Prereading and reading the SAME day • Mental participation during lecture – Core content guessing – Active listening