The GOOD and BAD Rules of Studying

There's a joke among students that studying really means stuDYING and after doing your studies you stuDIED. We have been studying for so many years from preschool to grade school, high school and college. And by the time we enter medical school, we have been students for 15-18 years of our lives! Although we are students for that long already, sometimes we feel that we still do not know how to study efficiently and effectively. We still search for the best methods of studying — what will work for us and what won't work for us. If we cannot claim that we are good students, perhaps we are breaking the rules of good studying.

Since it is exams week again, I'm sharing this article excerpted from A Mind for Numbers: How to Excel in Math and Science (Even if You Flunked Algebra) by Prof. Barbara Oakley Penguin, July 2014, with emphasis added. I only injected some annotations to tailor it for medical students. Check whether you follow the good rules or the bad rules of studying.

  

10 Rules of GOOD Studying

 1. Use recall. After you read a page, look away and recall the main ideas. Highlight very little, and never highlight anything you haven't put in your mind first by recalling. Try recalling main ideas when you are walking to class or in a different room from where you originally learned it. An ability to recall - to generate the ideas from inside yourself - is one of the key indicators of good learning.
> Take note, med students, it says, highlight very little! I've seen so many students who are highlighter happy - highlighting almost the entire page with multi-colored pens! I even told a classmate that maybe she needs a big paintbrush so it would be easier for her to highlight her book! If you are one of those highlighter happy students claiming that highlighting is effective for you, I challenge you to highlight less and use recall more and let's see the improvement! 

2. Test yourself. On everything. All the time. Flashcards are your friend.
> I am a believer of flashcards. However, it is time-consuming to make flashcards for each subject (we have a dozen of subjects this semester) and difficult to organize them all. When I was in first year, I make traditional flash cards on index cards and colored pieces of paper, but with the sheer amount of flashcards I have accumulated, I switched to using digital flashcards which are easier to make and more efficient to use.

3. Chunk your problems. Chunking is understanding and practicing with a problem solution so that it can all come to mind in a flash. After you solve a problem, rehearse it. Make sure you can solve it cold — every step. Pretend it's a song and learn to play it over and over again in your mind, so the information combines into one smooth chunk you can pull up whenever you want.
> Yup, the divide and conquer rule! 

4. Space your repetition. Spread out your learning in any subject a little every day, just like an athlete. Your brain is like a muscle — it can handle only a limited amount of exercise on one subject at a time.
> I cannot emphasize enough the importance of this! Studies have shown that spaced repetition is an effective way of acquiring long-term knowledge in medicine. Okay, so it's time to study EVERY SINGLE DAY even on weekends!

5. Alternate different problem-solving techniques during your practice. Never practice too long at any session using only one problem-solving technique — after a while, you are just mimicking what you did in the previous problem. Mix it up and work on different types of problems. This teaches you both how and when to use a technique. (Books generally are not set up this way, so you'll need to do this on your own.) After every assignment and test, go over your errors, make sure you understand why you made them, and then rework your solutions. To study most effectively, handwrite (don't type) a problem on one side of a flash card and the solution on the other. (Handwriting builds stronger neural structures in memory than typing.) You might also photograph the card if you want to load it into a study app on your smartphone. Quiz yourself randomly on different types of problems. Another way to do this is to randomly flip through your book, pick out a problem and see whether you can solve it cold.
> Problem-solving in medicine involves good clinical reasoning and the use evidence based medicine. Sometimes diagnosing can be quite tricky to because patients may have the same chief complaint but have different manifestations and clinical courses.
> In med school, computerized transes are the bread and butter of students. It is uncommon to see someone whose notes are all handwritten. Why? Because typing is way faster than handwriting and typewritten notes look neater and more organized than our already doctor-like handwriting! I guess, we have to do more handwriting now! 

6. Take breaks. It is common to be able to solve problems or figure out concepts in math or science the first time you encounter them. This is why a little study everyday is much better than a lot of studying all at once. When you get frustrated with a math or science problem, take a break so that another part of your mind can take over and work in the background.
> Studies say that working or studying in chunks with breaks in between is better than working in long hours in one sitting. Good, let's take a break. NOW!

7. Use explanatory questioning and simple analogies. Whenever you are struggling with a concept, think to yourself, How can I explain this so that a ten-year old could understand it? Using an analogy really helps, like saying that the flow of electricity is like the flow of water. Don't just think your explanation - say it out loud or put it in writing. The additional effort of speaking and writing allows you to more deeply encode (that is, convert into neural memory structures) what you are learning.
> It's true! Studying medicine is so complex! It's like learning a very difficult foreign language but you will eventually get the hang of it. But of course, not all patients can understand the medical jargon, so we have to explain in simple terms and in the language that they can understand.

8. Focus. Turn of all interrupting beeps and alarms on your phone and computer, and turn on a timer for 25 minutes. Focus intently for those 25 minutes and try to work as diligently as you can. After the timer goes off, give yourself a small, fun reward. A few of these session in a day can really move your studies forward. Try to set up times and places where studying — not glancing at your computer or phone — is just something you naturally do.
> That's the Pomodoro technique — studying for 25 minutes and taking a five-minute break, then repeat the cycle. I only knew about this technique last year and I've been doing it since then. It works for me because of my short attention span. :D

9. Eat frogs first. Do the hardest thing earliest in the day, when you are fresh.
> Did you know that eating frogs makes you productive? Nah, I'm just kidding, of course! "Eat that frog" is a classic management aphorism which means doing your most difficult and most important tasks in the morning when you still have lots of energy, so that the rest of your day will be a breeze. But I doubt it can be applied all the time in med school because of both the structured schedule and ever-changing schedule.

10. Make a mental contrast. Imagine where you've come from and contrast that with the dream of your studies will take you. Post a picture or words in your workspace to remind you of your dream. Look at that when you find your motivation lagging. This work will pay off both for you and those you love!
> Imagine yourself a physician working in hospitals and communities. Imagine your name with an MD added to it. Dream. Believe. Survive.

10 Rules of BAD Studying

1. Passive rereading. Sitting passively and running your eyes back over a page. Unless you can prove that the material is moving into your brain by recalling the main ideas without looking at the page, rereading is a waste of time.
> How many medical students are guilty of this? Let me see a show of hands. A see a lot! Including me! 

2. Letting highlights overwhelm you. Highlighting your text can fool your mind into thinking you are putting something in your brain, when all you’re really doing is moving your hand. A little highlighting here and there is okay — sometimes it can be helpful in flagging important points. But if you are using highlighting as a memory tool, make sure that what you mark is also going into your brain.
> Again, don't be highlighter happy!

3. Merely glancing at a problem’s solution and thinking you know how to do it. This is one of the worst errors students make while studying. You need to be able to solve a problem step-by-step, without looking at the solution.
> Yeah, I have been a victim of this in the computations in pediatrics and pharmacology!

4. Waiting until the last minute to study. Would you cram at the last minute if you were practicing for a track meet? Your brain is like a muscle — it can handle only a limited amount of exercise on one subject at a time.
> BUT cramming is a way of life for med students! :'(

5. Repeatedly solving problems of the same type that you already know how to solve. If you just sit around solving similar problems during your practice, you’re not actually preparing for a test — it’s like preparing for a big basketball game by just practicing your dribbling.
> That's ridiculous! Study a topic you know little or nothing about.

6. Letting study sessions with friends turn into chat sessions. Checking your problem solving with friends, and quizzing one another on what you know, can make learning more enjoyable, expose flaws in your thinking, and deepen your learning. But if your joint study sessions turn to fun before the work is done, you’re wasting your time and should find another study group.
> IKR! Sometimes chat sessions are longer than study sessions! A common pitfall of a "study" group.

7. Neglecting to read the textbook before you start working problems. Would you dive into a pool before you knew how to swim? The textbook is your swimming instructor — it guides you toward the answers. You will flounder and waste your time if you don’t bother to read it. Before you begin to read, however, take a quick glance over the chapter or section to get a sense of what it’s about.
> Reading the heavy and thick medical textbooks is a challenge among students! There are times that we go to class without ammunition because we failed to finish reading the chapters from the books, so we resort to reading transes and reviewers instead, which sometimes get us reprimanded by our professors and doctors.

8. Not checking with your instructors or classmates to clear up points of confusion. Professors are used to lost students coming in for guidance — it’s our job to help you. The students we worry about are the ones who don’t come in. Don’t be one of those students.
> Don't be afraid to ask questions — doctors gladly and generously share their knowledge and clinical experiences — if we only ask.

9. Thinking you can learn deeply when you are being constantly distracted. Every tiny pull toward an instant message or conversation means you have less brain power to devote to learning. Every tug of interrupted attention pulls out tiny neural roots before they can grow.
> Think, think, think. Apply your mind!

10. Not getting enough sleep. Your brain pieces together problem-solving techniques when you sleep, and it also practices and repeats whatever you put in mind before you go to sleep. Prolonged fatigue allows toxins to build up in the brain that disrupt the neural connections you need to think quickly and well. If you don’t get a good sleep before a test, nothing else you have done will matter.
> Oh, yes! Medical students and doctors are sometimes crazy. We advice people to get enough sleep, but we don't practice what we preach. Zzzzzzzzz...

So, how is your study habit? How many of the good rules of studying do you follow? How about for the bad ones? Do you have your own rule in studying? Share it with us!