As students, we are constantly taught that pathology is the basis of all medicine and forms the essential bridge between the basic medical sciences and the clinic. Almost all US medical students know that some elements of pathology will be found in more than two-thirds of USMLE 1 exam questions. I study medicine at the University of Zagreb School of Medicine, Croatia, and I often hear older colleagues say that if you learn pathology well, you are already a doctor. Of course, that is not actually the case, but after many clinical rotations, I now understand what they mean and, reflecting on my third year, I’m glad I studied pathology as hard as I did because it made my subsequent years at medical school much easier.
It takes six years to become a licensed medical doctor in Croatia, consisting of 78 subjects to learn and exams to pass. At my school, pathology is taught as a preclinical subject over the course of eight months. In the final oral exam, students are expected to know almost everything from our general and systemic pathology textbook – an 800-page Croatian textbook that is comparable to the world-famous Robbins Pathology series. My pathology textbook helped me to reassess my studying techniques and develop better strategies, but I also found several scientific papers and YouTube videos that demonstrated how underlining textbooks, taking notes, and repeatedly reading information or making mind maps are not as efficient as practicing active recall (1).
Now, I wish to share my study experience with incoming students, but also professors who are incredibly important – and sometimes crucial – in the process of remembering material. Why remembering and not studying? I believe remembering information should always be our priority – I studied a lot, but eventually I realized I best remembered answers to well-made questions. How does my method correspond with research showing how active recall outperforms all other study methods (2)? Let me explain…
How I practice active recall is actually quite simple. When reading information for the first time, I instantly create corresponding electronic flashcards using PowerPoint. After reading each paragraph of a chapter, I come up with questions on what I think are the main points and write the answers underneath, but animate the slide to keep them hidden for future self-testing. Each slide consists of one flashcard question; therefore, you can expect to generate around 300 flashcards for a subject like pathology. Of course, you can’t include everything, but it’s useful for memorizing long lists of facts.
Though I use PowerPoint, there are many sophisticated apps and tools for creating flashcards, such as Anki or Quizlet, which you can use to set stepwise goals and track your progress. Ebbinghaus’ Forgetting Curve describes the decline of the brain’s ability to retain information over time and, though disappointing and realistic, once flashcards are created they are easily revised at any time and can help to curb the effects of this phenomenon.
I have always been a curious person, which is why I believe that practicing active recall by creating flashcards can be exciting and engaging for other curious learners. Personally, I can maintain attention for longer when I create my own flashcards and they have helped me build self-confidence before oral exams, which are particularly important in my medical school. Oral exams require a further set of skills compared with multiple choice questions; flashcards can help by organizing your thoughts and making your speech concise.
Based on my experience, I encourage professors to leverage active recall in their lectures by asking rhetorical questions and providing the answers; I promise, many students will appreciate it. Also, make sure to cross-question the topic on your slides to allow students to think about the material that was covered. I’m not saying that everyone should fully rely on the active recall method, but definitely give it a try during your next study session – it might just surprise you.
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References
- J Dunlosky et al., “Improving Students’ Learning With Effective Learning Techniques: Promising Directions From Cognitive and Educational Psychology,” Psychol Sci Public Interest, 14, 4 (2013). PMID: 26173288.
- JD Karpicke, JR Blunt, “Retrieval practice produces more learning than elaborative studying with concept mapping,” 331, 772 (2011). PMID: D: 21252317.
