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Many common study habits and prac2ce rou2nes turn out to be counter-‐produc2ve. Underlining and highligh2ng, re-‐reading, cramming, repe22on etc. create the ILLUSION of mastery that quickly fades. More complex and durable learning comes from self-‐tes2ng, introducing certain difficul2es in prac2ce, wai2ng to re-‐study new material when a liFle forgeGng has set in, and interleaving the prac2ce of one skill or topic with another. Memory plays a central role in our ability to learn – whether it’s complex cogni2ve tasks or knowledge. Cogni2ve psychology has given us insights in to how memory is encoded, consolidated and later retrieved – this gives us a beFer understanding of how we learn. “Memory is the mother of all wisdom”
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A lot of what we think we know about how to learn is wrong – it is based on intui2on but does not hold up to empirical research. Most of what we do gives us the ILLUSION of learning … that quickly fades from memory.
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EfforTul learning (as occurs in spaced/interleaved prac2ce etc. – see later) requires that you re-‐load or reconstruct components of the skill or material anew from long term memory rather than mindlessly repea2ng them from short-‐term memory. During this focussed, efforTul recall, the learning is consolidated. Connec2ons to prior knowledge are strengthened. Examples of undesirable difficul2es: When the learner has no background knowledge or skills to have any retrieval processes. In this case, engaging in the learning described here is not helpful. Otherwise, a difficulty that learners can overcome through increased effort is a desirable difficulty.
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Our brains are like a FOREST. Your memory is in there somewhere. You’re here and the memory is over there. The more 2mes you make a path to that memory, the beFer the path is, so next 2me you need the memory, it’s going to be easier to find it. But as soon as you get your notes out, you have short-‐circuited the path. You are not exploring for the path any more, someone has told you the way.
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Set aside 2me every week throughout the course/revision programme to quiz yourself on material. BOTH the current week’s work and previous weeks. Use quizzes to iden2fy areas of weak mastery and focus your studying to make them strong. THE HARDER IT IS FOR YOU TO RECALL NEW LEARNING FROM MEMORY, THE GREATER THE BENEFIT OF DOING SO. Making errors will not set you back, so long as you check your answers and correct your mistakes. Your intui2on will tell you to focus on underlining and highligh2ng text, and re-‐reading and becoming fluent in the text – this is the illusion of learning. Ager one or two reviews of a text, self-‐quizzing is far more potent for learning than addi2onal re-‐reading. This helps you focus on the central precepts, and provides you with a reliable measure of what you have learned and what you have not yet mastered. The habit of regular retrieval prac2ce throughout the dura2on of a course strengthens your learning of it and your ability to connect it to prior knowledge. Compared to re-‐reading, self-‐quizzing can feel awkward and not as produc2ve – but every 2me you work hard to recall a memory you actually strengthen it.
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If you use flashcards, don’t discard the cards you answer correctly a few 2mes. Intui2on tells us to dedicate stretches of 2me to single-‐minded, repe22ve prac2ce of something we want to master -‐ “massed prac2ce”. We believe this is essen2al to build mastery of a skill or learning new knowledge. We see our performance improving as we prac2ce something over and over again, which re-‐inforces the illusion of learning. But this comes from short term memory and quickly fades. Yes, we learn through repe22on and lots of prac2ce, but only if it is spaced. Space out your study sessions so a liFle forgeGng has happened, then you will have to work harder to reconstruct what you have already studied. You are re-‐loading it from long term memory. This effort to reconstruct the learning makes the important ideas more salient and memorable and connects them more securely to other knowledge and to other more recent learning. It’s a powerful learning strategy. Massed prac2ce feels more produc2ve than spaced prac2ce; spaced prac2ce feels more difficult because you have got a liFle rusty, and you feel like you are not really geGng on top of the subject – whereas the opposite is happening: as you reconstruct learning from long-‐term memory, as awkward as it feels, you are strengthening your mastery as well as the memory.
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How much 2me should you leave between study sessions? Enough so that prac2ce does not become a mindless repe22on. Enough 2me so a liFle forgeGng has set in. A liFle forgeGng leads to more effort in prac2ce, but you do not want to forget everything so retrieval becomes essen2ally re-‐learning material. SLEEP seems to play a large role memory consolida2on, so prac2ce with at least a day between sessions is good. Flashcards can provide an example of spacing. But beware the familiarity trap – the feeling you know something and no longer need to prac2ce it.
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Once you reach the point where you understand and new topic but only basically, scaFer this topic throughout your reading/prac2ce/self-‐quizzing so you are mixing up different topics/prac2ce/skills. Your intui2on tells you to really focus on mastering one thing at a 2me before moving on. But mixing problem types/topics/prac2ce/skills improves you ability to discriminate between problems, paFern recognise, and improves success in later tests or real world prac2ce where you need to discern the kind of problem you are trying to solve in order to apply the correct solu2on. Blocked prac2ce feels beFer – like you are mastering something before you move on. Whereas interleaved prac2ce feels disrup2ve and counterproduc2ve. But research shows this is an illusion – remember, effec2ve learning feels more difficult.
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THINK – how will you do things differently now?? Case study: medical student. Student A was really in to reading, but that’s all he knew how to do studying. He studied studies about learning and changed his technique – with drama2c improvements in his grades. He would be more mindful of what he was reading. He would stop and ask, ok what did I just read, what is this about, then go back and check if he was way off track or on course. This process did not come naturally at first. Stopping in this way felt slow. He introduced spaced retrieval prac2ce in to his study techniques. He also learned to priori2se learning what was important, deciding what were details (not key concepts) that could be discarded. He slowed down the speed at which he read material in order to find the meaning, using elabora2on to beFer understand it and lodge it in his memory. Remember, elabora2on is the process of finding new layers of meaning in material, explaining it in your own words, turning text in to a diagram in order to visualise it, explaining it to someone else/teaching it, using an analogy or a metaphor or a visual image etc. Case study: psychology major Student B was very successful and he shared his way of learning with fellow students. He always read the relevant material prior to a lecture An2cipated test Qs and their answers as he reads Answers rhetorical Qs in his head during lectures to test his reten2on of the reading Reviews study guides, finds terms he cannot recall or does not know and relearns those terms Copies bolded terms and their defini2on in to a notebook, making sure he understands them Takes the prac2ce tests provided on-‐line by his Professor Re-‐organises the course info in to a study guide of his own design Writes out concepts that are important, posts them above his bed and tests himself on them from 2me to 2me Spaces out his review and prac2ce over the dura2on of the course.
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A KEY ASPECT OF LEARNING MEDICINE (knowledge) IS THROUGH CLINICAL EXPERIENCE. Books + clinical experience (not one or the other). Also important for exams! *How can you get the most out of every clinical experience? In other words, how can you gain process feedback? (as opposed to ‘outcome feedback’).
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There ARE cogni2ve differences in how people learn. But the tradi2onal learning styles theory that some people are at a disadvantage when teaching is not in their style is NOT supported by evidence. There are a few other more interes2ng differences psychologists have observed: Some people are beFer at STRUCTURE BUILDING – the act, when they encounter new material, of extrac2ng salient ideas and construc2ng a coherent mental framework out of them (mental maps). People who are not so good at this have problems seGng aside irrelevant or compe2ng informa2on and as a result tend to hang on to too many concepts to be condensed in to a workable model that can serve as a founda2on for further learning. Another difference is whether you are a RULE LEARNER or an EXAMPLE LEARNER. Rule learners extract underlying principles, whereas example learners memorise the examples rather than the underlying principles. Good structure builders and rule learners are beFer at transferring their learning to unfamiliar situa2ons.
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Explain to students how learning works: Some kinds of difficul2es during learning help to make the learning stronger and beFer remembered. When learning is easy, it is ogen superficial and soon forgoFen Not all our intellectual abili2es are hard-‐wired. In fact when learning is efforTul, it changes the brain, making new connec2ons and increasing intellectual ability. You learn beFer when you wrestle with new problems before being shown the solu2on, rather than the other way around. To achieve excellence in any sphere, you must STRIVE to surpass your current level of ability Striving, by its very nature, ogen results in setbacks, and setbacks are ogen what provide the essen2al informa2on needed to adjust strategies to achieve mastery Teach students how to study: Students generally are not taught how to study, and if they are, are ogen given wrong advice. They gravitate to ac2vi2es that are far from op2mal, like re-‐reading, massed prac2ce and cramming. Students will benefit from teachers who help them understand effec2ve strategies and s2ck with them long enough to experience their benefits, which may ini2ally appear doubTul. Create desirable difficul2es in the classroom: When prac2cal, use frequent quizzing to help students consolidate learning and interrupt the process of forgeGng. Create study tools that incorporate retrieval prac2ce, genera2on and elabora2on. These might be exercises that require students to wrestle with a new problem before being taught the solu2on, prac2ce tests for calibra2on, wri2ng exercises that require students to reflect on past lesson material and relate it to other knowledge, or summary statements of material covered in a course or lecture. Quizzes and exercises should reach back to concepts and learning covered in earlier sessions, so that retrieval prac2ce con2nues and learning is cumula2ve, helping students construct more complex mental models, strengthen conceptual learning and develop deeper understanding of rela2onships between ideas/topics.
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Please read these two books to understand the material in these slides in more detail. The info in these slides is taken from the first one “Make it S2ck: the science of successful learning”. This describes effec2ve evidence-‐based teaching and learning techniques and shows that intui2ve methods are far less effec2ve. Most of the 2me we use techniques that are not very effec2ve but give us the illusion of learning – an ALS course for someone who does not run a crash team would be a good example in medicine. The second book “Bounce” by MaFhew Syed is a wonderful layman’s summary of the academic literature on exper2se – how to become really good at something. This is par2cularly relevant to learning in clinical prac2ce (work-‐based learning) and also expands on the idea of “mind-‐set” as being important in geGng beFer.
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