Let the Good Times Roll…on Medical Education: Effective Study Habits

Catey Harwell, MS2


Last week, I attended the Northeast and Southern GSA/OSR Joint Regional Meeting in New Orleans along with my fellow UofL OSR reps. The AAMC hosts a conference for their Group on Student Affairs (GSA) and Organization of Student Representatives (OSR). This Spring, it was a joint conference with the Southern and Northeast regions. The states included in these regions are listed below.

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One particularly interesting session, at least to me, outlined study behaviors that have been shown to be effective and ones that have been shown to be ineffective in the literature. For example, behaviors that do NOT work include:

-Re-reading – this is passive and it can provide a false sense of knowing the material

-Laptop note taking – students are not forced to summarize and identify main points, which are considered important for effective, active learning

– Study aids – basically someone else is doing all the work

– Highlighting – this may actually hurt performance (!); it doesn’t help connect concepts across chapters/paragraphs

– Flash cards – when you make them yourself, you often don’t have time to use them effectively

What DOES work:

– Time management – taking the time to put together a study schedule helps you manage your time effectively; planning ahead also allows for “distributed practice” (rather than trying to learn everything in one cram session)

– Selecting main ideas – summarizing and identifying key points facilitates learning and retention

– Actively process information – each person select different information that he/she needs to focus on (i.e., don’t just copy your classmates notes from class)

– Practice retrieval – basically, self testing; start early – don’t wait until the day before you take the exam to start doing practice questions, you need to be consistent with it

While some people may mourn the fact that highlighting has not been demonstrated to be an effective studying tool, what I’ve found that seems to work for me is a multi-modal approach – I’m listening to a lecture, reading along, and taking notes in the margins on key points all at the same time. And questions…lots of questions, in a simulated test-taking situation, too, with adequate, thorough review of the answers. At least, so it goes in an ideal study world. I’ve got the study schedule in place for Step 1, now it’s just down to the execution.

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Learning moves outside the lecture hall

Beth Seagraves Brooke, MS1


Along with a systems-focused curriculum, this semester brings new learning experiences. Though most days are still spent in our lecture hall, we now have days when we learn outside the classroom.

In problem-based learning (PBLs), groups of students gather to discuss clinical cases. The first dealt with an aortic dissection. Using information we learned in class, we discussed the patient’s vital signs, lab tests and scans. We arrived at a diagnosis and differentials. After listing several learning objectives, we agreed on a handful that we researched on our own that evening.

The following day, we shared what we learned and discussed the original diagnosis and eliminated differentials. We listed what symptoms were common among aortic dissections and aneurysms and what we, as future physicians, needed to be thinking of when ordering urinalysis, blood tests and X-rays.

I found the PBLs a laid back, fun way to practice using the information we’ve been learning this year. It’s also a great way to practice working with a team to arrive at a diagnosis and treatment plan for a patient. We have another PBL in a couple weeks integrating information on respiratory and renal systems.

We’re also spending more time in the Paris Simulation Center, which houses the school’s simulated patients. In small groups, we work with a Ph.D. and a M.D. to discuss a clinical case. The simulated patient’s physical status changes to mimic worsening conditions or improvement as we progress through the case.

Last week, since we were learning respiratory, we discussed pneumothorax.

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Caption: Dr. Matthew Bozeman walks first year students through treatment of a pneumothorax.

The case centered around a patient who was struck in the chest during a soccer game. His blood pressure was dropping, his respiration rate was elevated and his O2 levels were down. Through each step, we discussed arterial blood gas (ABG) levels, metabolic panel and vital signs. We also used a stethoscope to hear diminished lung sounds on the simulated patient’s left side and discussed his X-ray.

The purpose of the simulations (SIM Lab) is to show us how the concepts we learn in class apply to clinical situations. It gives us an opportunity to think through the physiology of the patient’s case and gain a better understanding how the body responds to an injury, pathology or treatment.

Next to clinical rotations and preceptorships, it’s hands-on learning at its best.

AAMC Learn, Serve, Lead 2014: A Weekend in the Windy City

Catey Harwell, MS2


 

The conference started out early Friday morning for Rudra and me with a day of OSR meetings – that is the Organization of Student Representatives, which is the student branch of the AAMC. The OSR is subdivided regionally into a Southern OSR, which ULSOM is a part of; Northern OSR; Western OSR; and Central OSR. These meetings are a great opportunity to meet students from other medical schools and learn about what things they do differently, what works well, and what things could be improved.

A few of the topics we discussed include similarities and differences of TBL at our respective medical schools, research during medical school, and methods of informing students on health care reform. We look forward to bringing the ideas we gathered from meeting and talking with students from other schools back to ULSOM. We are always on the lookout for cool and exciting projects to introduce back at home.

I also learned about “milestones”. For those of you not familiar with milestones as I was, the idea behind it is just the same as those used to evaluate developmental progress in children. They are being used primarily in residency to evaluate resident performance in the six ACGME Core Competencies. These are: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. Duke University is exploring ways of integrating milestones into the clinical curriculum at their school. To learn more about milestones, information is available on the ACGME website.

Allison arrived in Chicago from Cleveland where she was doing an away rotation on Friday night. It was great to have the whole team together again! Saturday morning we all attended a terrific session during which Alan Alda, who starred in the TV show M*A*S*H, discussed his effort to improve communication skills of scientists and health professionals with the public through the creation of the Center for Communicating Science at Stony Brook University (more information here: http://www.centerforcommunicatingscience.org). He had some great stories to share about some not so great experiences that he has had with physicians. He even got the audience involved on more than one occasion! In one demonstration, he invited someone from the audience to come up on stage and tap out the rhythm to a well-known song. An astonishingly small percentage of the audience was able to recognize the song based on this woman tapping it out. His point was that even though something may be clear to us in our head (just as when the woman tapped out the rhythm to the song), the person we are explaining something to may think it just sounds like a bunch of words that don’t make any sense together and is totally unrecognizable.

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Alan Alda presenting at AAMC Learn, Serve, Lead 2014

 

Saturday afternoon we ventured to “The Bean” in Millennium Park and met up with the OSR reps from University of Oklahoma. The Bean was crowded, but it made for a great photo op! Breakfast for lunch was also the order of the day so we packed it in at Wildberry Pancakes, a popular breakfast and brunch spot in the city.

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From left to right: Allison Hunter, MS4; Catey Harwell, MS2; Rudra Pampati, MS3. In Chicago at “The Bean” (officially named Cloud Gate) in Millennium Park.

 

Sunday was finally our day to present our poster on updates to the College System. Despite the short 45-minute time slot and the poor resolution on the monitor (this was a new method of poster presenting for all of us I think!), we drew some great interest from representatives from other schools. Many schools seem to have implemented something similar, but few have extensively integrated aspects of clinical advising, vertical mentorship, community outreach, and student wellness initiatives.

We also had just enough time before returning to Louisville to stop by the Firecracker booth for some study tips and caricatures!

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Caricatures courtesy Firecracker!