Kathleen is an expert in helping premeds and medical students better prepare for their exams. With her evidenced-based practice, she’ll help you too. Today, we talk about how you can study better — what you should be doing before, during, and after class — and so much more!
Please check out all our other podcasts on MedEd Media Network to help you along your journey to becoming a physician.
[01:50] Kathleen’s Background
Kathleen started in 1988 working for a company to work with the medical office of academic advising. Just after finishing her Master’s program, she was looking at reading strategies and how students learn to read. She realizes that at that time, medical students were required to read about a thousand pages a week and it has only increased since then. So she wanted to figure out how to be a more efficient reader. She then got hired by Eugenia Kelman, who eventually became her co-author and mentor and a really good friend. Together, they have put together an entire system for med students to be really effective and really efficient in their study strategies.
[03:05] How Is It Humanly Possible to Read that Much?
The secret as that you’re probably not going to read every single word. One of the strategies is to read to make notes. You’re going to be actually extracting material from the textbook to make your own notes of information that you don’t know. However, a lot of students spend much time studying information they do know but if you already know it, then obviously, you don’t need to spend as much time. This is a hard shift for students but it’s going to be a more efficient use of your time.
If you’re studying for the first time, what you can do is perform a self-test. There’s research behind that called the Testing Effect. What they found is that if you self-test, it helps you remember more of the information. Then you’re going to know where you’re going to be spending your time.
[04:44] How to Self-Test
If you have review books you’re going to need in the future, you can do a self-test from that. Or if you have a good set of notes, self-test to know what you do and don’t know.
Resources you can use include Clutch Prep, Khan Academy, and Cheggs as well as Quizlet and Anki. They often have questions you can use. This is going to be a shift in the way you think about preparing but it’s going to be really good.
[06:36] The Biggest Mistake Students Make
Even when preparing for the MCAT, the biggest mistake students make is they don’t do enough practice tests to understand where their strengths and weaknesses are. So they can focus on those weaknesses. Instead, they just read content, thinking they’re just going to read and read and read and they’ll be fine.
Reading and reviewing are putting information in your brain, but the exams aren’t really testing what’s in your brain. They’re actually testing what you can pull out of your brain. This is where the self-testing is when you get to practice the opposite, which means pulling it out of your brain. They call this retrieval practice.
These have just been underutilized. You haven’t worked them enough. They don’t know what to do. Or even if you did, maybe not in a timely manner. Maybe you’ve thought of it right after you left the testing room.
[08:30] Medical Students Relying on Brute Force Intelligence
Kathleen worked with some university students. They did it after the first round of exams before they actually offered the workshop. After they scored lower for the first time in their entire life, they’ve literally got students lined out the door to come to the workshop to see what they could do to improve. So they needed a proof that they needed help before they would seek it.
As to why such switch upon going to medical school from doing so well, say during undergrad, Kathleen thinks they’ve been relying on their native intelligence. Some students call it brute force intelligence. They’ve been using strategies they’ve always used and it worked until hitting medical school and find out that the pace and the volume are something they’ve never experienced before. This is where the efficiency needs to come in.
[10:25] Frameworks to Develop Your Study Habits
Depending on where you are on your premed journey, you can get a 1, 2, 3, or 4-year headstart and have these study strategies just to be a natural part of how you study. Kathleen, in fact, helped a senior in college and she said some freshmen walked up to her one day telling her how she’s studying wrong and showed her how. Now she’s a third-year med student.
Some frameworks you can use include time management, which is how you spend your time while you’re awake; mind management, which means all the thoughts going through your head; and then body management, which is how you take care of yourself through sleep, nutrition, etc.
Within the time management part, that’s where the learning process flow chart comes in. They teach students how to prepare before they go to lecture and then they teach them what to do with the information, their lecture, and textbooks. They also teach them how to review and self-test. This used to be the last stage but they’ve added in another stage where they teach students how to score and analyze their self-tests. So when they walk into a class exam or an entrance exam, they know the information.
[12:20] Good, Better, and Best
For instance, you have an hour-long lecture coming up, the time you put into pre-read depends on what approach you want to take. Kathleen has three different approaches you can take she calls, Good, Better and Best.
Good: Just take ten minutes and look over the material before you go in so at least you’re familiar with the vocabulary words because this is going to help you during your lecture.
Better: Do your quick pre-read but then go back and read the chapter to give you even more information.
Best: Pre-read and make notes before you go to class. Then the class becomes a review of information instead of an introduction. You walk out of class with a complete set of notes then you go on to the next topic.
A lot of schools are actually moving to this Flip Classroom framework where they expect the students to learn the material outside of the classroom and then the class is only for discussing and asking questions and following up and flushing out the material. This is what Kathleen is setting up for these students since as you get to the higher levels in education, more and more of the learning is put back on the learner.
[14:50] Teaching as Part of Learning
Now, the next steps again depend on what you do before class as well as after class. Kathleen cites an example of her student who got hold of her book and went over it before he started first-year college. He wasn’t satisfied with just knowing the information for himself. So he’d pre-read then get together his group of friends who were in the same class he was, and he’d the information he had already learned to them so then everybody went to class prepared. It saved the work they had to do afterward because of the work they’ve done before.
Moreover, teaching has been shown to be one of the best ways to not only solidify your knowledge but to also know and give you confidence that you know it because you’re able to teach it. Hence, we highly recommend study groups, specifically for the MCAT. One person is good at one section, and another is good at another section. So you’re teaching other people.
[16:40] The Biggest Struggle for Students
Time is always a huge issue because we’re only allotted 24 hours a day and learning to use that time efficiently and effectively is really huge. Next is being systematic in your approach to your studies. Most students are not used to having a system because they’ve been smart and been able to get through just their native intelligence. So it’s a struggle for them to incorporate new habits.
Kathleen sees a lot of mental barriers among students to change. That said, she has seen many students who have faced all sorts of challenges that most of us will never have to face. They were able to overcome incredible things because of the way they’ve talked to themselves. This is the mind management part and the determination they have.
One of the things Kathleen requires from her students who wish to work with is they have to be motivation. Otherwise, how can somebody else help you if you don’t care as a student? So a lot of the internal dialogue is a big part of it.
[21:15] Dealing with Devices and Distractions
In terms of using your mobile phones and other devices, they’re becoming a problem for efficiency and effective learning. Literally, the farther the phone is away from you, especially if it’s not in your line of sight, the less distracted you are by it. What you can actually do is put it off first and then put it in a different room.
Upon surveying her students, Kathleen found out that they still prefer reading from their textbooks than they do from any of their devices. Kathleen thinks that reason for this is because of your intent for doing this. Since when you hold a book, your only intent is to read it, rather when you use your phone, you could be doing so many other things with it aside from reading.
[25:20] Developing Self-Awareness
Kathleen has developed a number of tools and exercises that help students discover what those triggers may be for you. And until you’re aware of it, you obviously can’t do anything about it. She’d often have students guilty of their past behaviors but they didn’t know. But now that they know, they’ve got a choice to make – either change things to change that behavior or just pretend it’s going to be okay if you wish it to be.
[26:30] Does the Pomodoro Technique Work?
Kathleen says this could be helpful when you’re in college, but at some point in time, you’re going to have to learn to study for longer periods of time and you’ll earn a longer break afterward. It’s because you’ve got so much information to get through once you get to professional school. So there’s a level of training for study endurance that needs to take place.
[27:02] Gaining Focus and Concentration
Kathleen’s co-author, Eugenia Kelman, is a behavioral psychologist by training and she came up with 7 different factors that affect concentration. They have quizzes and exercises in the books they’ve written together. Kathleen explains that when you think about concentration, you talk about it like it’s just one thing. But there are 7 levels that she found and using these exercises can help students learn to focus and concentrate better. Some include being awake and alert such as the location you’re in.
Internal distraction is one of them too. So if you’re worrying, you can write down what those thoughts are so they’ll quit swirling around in your brain. Then you’ll have something concrete to act on later.
An example of external distraction would be like beds or if you try and study at Starbucks and they have those noisy machines. Again, location. Another one of them is your mood or attitude control. If you’re going to a study session and think it’s so boring, then you’re going to have a less efficient study period than being positive about it.
[31:55] The Best Times of the Day to Learn
Figure out what is the best for you. We can have habits we do over and over and we think it’s what we do best but it may not be. Kathleen has a concentration monitoring sheet where students are able to monitor their concentration levels throughout the day.
And they found out that students are better able to concentrate better in the morning. It’s probably because after a good night’s rest, you tend to be fresher and you don’t have the weight of the day on you yet. You have the whole day ahead of you so you just have a better state of mind. But base this on reality instead of just how your past habits have been.
[33:40] Different Techniques for Different Classes?
Kathleen explains that different classes have different requirements for how you’re going to take in the information and how they’re going to be taken out for the exams. Som certain classes lend themselves to certain types of notes. For instance, in the Anatomy, you’re going to be making a lot of diagrams and probably category charts so you can learn the differences. But for the Physiology portion, it’s going to be tons of flowcharts because you need to learn the different processes. So yes, different classes are going to primarily require different note styles.
This said, always be prepared before you go to class. And whenever you’re reading, read with a purpose, which is to be able to make some notes from it. Then always review at some point, self-test, and then score and analyze that.
[35:08] How to Maximize Studying, Sleep, and Caffeine
Kathleen stresses that body management is so important. When we sleep, that’s when consolidation of information takes place. It puts information into your long-term memory. And it only takes place if you’ve been through all the different sleep cycles. But a lot of our students, or Americans in general, are not getting enough sleep, between 7 and 9 hours.
Moreover, dehydration is another factor that can make you all fuzzy. As for taking coffee, some researchers looked at caffeine and its effectiveness, and they’ve found that having it spread over the day is a better way to stay alert and awake without getting the jitters. You can take it 50 mg per hour until you’re within 6 hours before going to sleep. Since the half-life of caffeine is 5.7 hours. You can take in a lot less coffee and still get your level of alertness without overdoing it.
[39:10] Advice for Students with Learning Disability
The strategies they currently teach work for students with learning disability too, such as eliminating classroom distractions as well as avoiding someone using a computer. Interesting research found that a person taking notes with a computer is not the most distracted, it’s the person sitting next to them. There’s also that power of just using a pen and paper. Because when you’re typing, you can type a lot faster than when you write so you don’t tend to process anything. You’re just trying to transcribe word for word versus writing with a pen and paper where you get to think and reflect on the most important thing to write down.
[42:05] Check Out Their Books!
Kathleen has written three books with co-author Eugenia Kelman. Visit her website Study with Precision. Kathleen emphasizes to students that if they want to be professionals, learning to be precise in how they think, talk, and study is an important part of that process. Check out Study Without Stress, a book for medical students. They’ve also written one for nursing students called Vital Skills. And recently, a book for premed students is called Six Steps to College Success. They have also broadened this to include others in the STEM field.
[43:45] Final Words of Wisdom
Finally, Kathleen’s message to students is that there is a way to learn to be more precise and you’ll see better results. She’d be delighted to work with you!
Get a chance one of her books by going to medicalschoolhq.net/317 and leave a comment about what you’re struggling with in terms of your study habits.
Study with Precision (Kathleen’s website)
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