Frequently Asked Questions / Frequently Heard Comments

Topic: "It takes too long to do this active studying thing."

• "I need to go over my notes at least twice before the final so I don't have time for all those other steps."
  Active studying must replace passive studying, not add to it. Analyze what you are doing and delete all the passive steps. That includes going over your notes for the final. Use the active pattern instead.
• "It takes too long to make those summaries."
  Basically, if your studying isn't giving you the results you want, then you need to change your pattern — and there is a very good chance you need to integrate the material and memorize it better. Summaries are the best way to do this. They do take time to create, but use the "extra" time in the day and the time you previously used for passive studying to find time for this. Be sure you aren't recreating the wheel by copying over perfectly good (but not too pretty) charts or by recopying perfectly good charts from the text or syllabus. Photocopies work well and let you modify them as you need. Use a different color of ink to highlight important modifications.
• "I don't have time to pre-read."
  The active process is an integrated pattern that emphasizes overall efficiency, but each step depends on having performed the earlier steps. If you decide you don't have time to pre-read, your notes will be poor and you won't track much of the lecture. You just lost one iteration of the details (you'll need to make that up later) and you will need more time to fix your notes. Skipping a 15-minute process which then requires 30 minutes or more to make up for is a bad investment. If you've had a good course as an undergraduate, your pre-reading can probably be limited to memorizing the course outline.

Topic: "I still need to go over my notes and/or recopy them."

• "I need to go over my notes and/or the reading a couple of times to get familiar with it before I can make charts."
  Active pre-reading includes memorizing the major headings and subheadings in the course outline, syllabus and/or reading. That is the big picture. Reading the introduction and summary in the text as part of pre-reading reinforces this. So if you are having trouble with the big picture, be more rigorous in your pre-reading. Then fix your notes with the course outline/syllabus and text at hand and inserting the organizational headings into the notes super-imposes the big picture on them. Don't go over the notes a couple of times looking for the big picture — know it ahead of time and put it in.
• "I need to recopy my notes."
  Your notes are the rough draft that has all the possible information. Your summaries are the final draft with the picked information organized for integration and easy memorization. Don't worry about your notes being pretty, just well labeled and cross-indexed. Spend that time creating summaries instead.

Topic: "I don't want to go to lecture."

• "I never went to lecture as an undergraduate and did just fine. Why start now?"
  I don't recommend skipping lecture, since you are then missing the first chance to hear all of the details (if you actually pay attention) and review the big picture. Not to mention, this is the best place to find out what is likely to be on the exam (see FAQ below), which depends a lot on intonation and emphasis (not available in the class notes). The volume and rate of flow in medical school is a lot higher, and the analysis by the lecturer is a valuable tool you should use, not ignore.
• "I have an exam coming up, so I don't have time to go to lecture."
  The above answer applies here, too. In addition, the active process is an integrated pattern that emphasizes overall efficiency, but each step depends on having performed the earlier steps. If you do skip lecture for whatever reason, don't forget you need to replace both the analysis and review the lecture provides and the further studying you need to organize and memorize the material.
• "I don't like the lecturer and don't learn anything from him/her."
  Different lecture styles work better for different people, but the bottom line is that lecture is still the best place to find out what the professor thinks is important. If you aren't learning anything in lecture, pre-read more rigorously and memorize the headings and subheadings well enough that you won't get lost if the lecturer rearranges the order somewhat. Again, leave space if you lose track.
• "My note-taking is so bad that it is a waste of time to go to lecture."
  You still lose the experience of hearing the emphasis and extra explanation. And the only way to improve your note-taking is practice. As a physician, you will be continuing your education (and note taking) the rest of your life, so now is a good time to get better. Re-read the section on note taking for specific suggestions on how to improve it.

Topic: "How do I know what will be on the exam and practice for it?"

• "How do I know what will be on the exam?"
  1. Find out whether the exam is multiple choice, short answer, essay or problems — it does affect your studying. The types of summaries and charts described above work well for both types.
  2. How many questions will each topic get? Theoretically, the questions on an exam should be balanced to roughly parallel the proportion of lecture hours per topic. Of course, it doesn't always work out that way, but it is a place to start.
  3. How do I get practice on the kinds of questions that will be on the exam?
     • If one example is given to illustrate an equation or principle or graph, assume that any others are good subjects for exam questions. Look them up in your notes or text and work them out.
     • If the instructor gives a sample calculation, and the accompanying table has more examples, fill it in.
     • If practice problems or old exams are provided or assigned — do them!!! If the course includes conferences with assigned questions, be sure to analyze and answer all the questions that other students presented. There is a lot of difference between tracking logic outlined by the lecturer or text and applying principles in a way you have not seen before.
     • Don't save the old exams to test yourself prior to the exam!! (see the question below).
• "But I need to save the old exams to test myself at the end."
  Don't save the old exams to test yourself just before the exam!!! It is then too late to modify your studying. You may do well and be complacent, or do poorly and be a nervous wreck. So what? Start using the old questions as soon as you have created the summary for a particular topic — even before you have done the active memorization. Having it all memorized may only happen the night before the exam, and that is too late to be of use.
• "I need more old exams to study from; where can I get them?"
  The policy on old exams has changed recently. Each class is required to have a written policy on what old exams are available and where. All other exams are illegal to use or to have. Usually, exams from the previous year or more will be available. Used properly one, or at most two, old exams are plenty for preparation — see question below.
• "How do I use old exams to study from?"
  Don't save them to test yourself!! (see question below). Complete analysis includes:

  1. Analyze each exam question, don't just answer the questions and count up how many you got right. Whether or not you got the question right, analyze it thoroughly.
     • Make sure you understand why EACH possible answer is right or wrong and how each wrong answer could be made correct and what topic it was referring to.
     • If you didn't get it right, go back and memorize the entire chart or summary that contained it.
     • Ask yourself if there are any other examples that could easily be used with the same format.
  2. Make sure the information for each exam question is somewhere in your summaries or charts (not just the original class notes) — if not, add it and any equivalent information to any related categories.
  3. Try writing a few possible questions yourself, then answering them (or trade with a friend). This is a very powerful technique to having to analyze the material, know the big picture and know details.
• "I used the old exam and did well, but then I didn't do well on this exam."
  It will be a different exam and the predictive value of old exams is marginal, so don't depend on your score on the old exam. Thorough analysis of the exam questions (see above), and predicting a few harder ones, will be much more effective preparation.

  1. Check each class to be sure it is the same professors(s) and the same content!!
  2. The emphasis in lecture can change, even when the topics don't. And without the stress of the exam, you don't make as many mistakes and usually think more clearly. The old ones were almost always easier than the one you took — just ask anyone in any year.

Topic: "I need help with my test-taking strategies."

• "I understood the material, but I had trouble answering the questions. I have a problem with test-taking."
  Test-taking strategies can always be improved and can help the student display what he or she really does know, but usually most of the problem due to passive studying strategies.

  1. In many cases, the student understood general concepts but did not memorize enough facts clearly enough to analyze and answer the questions. Medical school requires a much greater level of clarity of information than undergraduate classes. Knowing how much detail to learn is difficult, and varies with each class; old exams can be helpful (another reason to use them early) as well as listening to the professor's emphasis during lecture (this often takes attention and practice, since each lecturer's style differs). One active studying pattern that works for many people is described above.
  2. In many cases, the student doesn't realize the difference between "familiarity" with the logic provided by someone else and synthesizing the material well enough to apply it to new situations. "Going over notes" only helps with "familiarity". Organizing the material in charts or diagrams requires synthesis and integration.
• "I always get it down to 2 answers and the always choose the wrong one."
  At least two different processes seem to contribute to consistently doing this:

  1. Students unconsciously equate effort with accuracy. So if it takes 3 minutes to justify one answer and only 30 seconds to justify another, the 3 minute answer is often picked; of course this usually means that it took more assumptions and tortuous reasoning to justify the 3 minute answer, which makes it less likely to be true.
  
  
  2. Students also frequently give more validity to impressions of "what your body wants to do" or "what the cell wants to do" than to actual known relationships or equations that describe reality. Often, a student will say something like, "Well, I knew that stroke volume times heart rate equals cardiac output, and answer 'b' fit that equation, but I though that stroke volume should be really important in determining MV02 because the heart wants to move all that blood, so I chose answer 'c'." Notice the difference between "knew" and "should".
     
     

     Technique:

     Use a marking system (e.g. "++, +, +/-, -, --" or TT, T, ?, F, FF) to assign a "truth" value to each answer as you first read it — before you agonize over any of them. For example:

     • TT is definitely true (you can think of an equation or fact that demonstrates it).
     • T is probably true (you can't think of a definite proof, but you have some supporting evidence or a strong hunch).
     • ? is one you are really not sure of.
     • F is probably false.
     • FF is definitely false.

     Think about each answer you aren't sure of, but don't change the original "truth" value unless you have a revelation of an equation or relationship you suddenly recognized or remembered.

     
     

     If the one you are agonizing over gets a +/- or ?, but the original has a + or T, go with the original.

• "I have trouble with those trick questions."
  Many "trick" questions aren't — they just require careful reading (so will prescriptions, etc).
  Common problems in this category include:

  1. Choosing the first correct statement, even though it is not the best answer to the question.
  2. Choosing a familiar association between two factors, even though that association does not work in the described scenario or the factors are related inversely instead of directly.
  3. Reading the first half of an answer and choosing it, without reading the second half and realizing that it makes the answer false.

  Techniques:

  1. For each answer, read the stem and that answer as one continuous statement.
     • Make sure the statement answers the question asked and is true under the conditions listed.
     • While reading each answer, make sure the entire statement is correct, not just half.
  2. Slow yourself down by underlining, boxing or circling relevant information in the question and jot down any useful equations or quick lists in the margin as a reminder.
     • Try to have a "back-up" alternative logic to verify your answer; emphasizing organization and connections during studying helps this technique this a lot.