Remember Everything: A primer

Remember Everything: A primer

How many of you have ever tried to learn something new? How many of you have ever failed at something you attempted to learn? Finally, how many of you think that you could study medicine and be successful? It is possible to remember far more than you think. I should know.

I’m a slacker. I slacked off in high school. I slacked off in both my undergraduate degrees. I slacked off in my IT work. I slacked off working in the warehouse. I even slacked off during my current medicine degree. I got a very big wake up call during mid-semester exams when I got 57% on the exam, an exam and course with a pass mark of 60%. That was when I realised I would not survive using my old techniques and I needed to learn new techniques. To be fair though common sense had made me realise this earlier and I just hadn’t actioned it.

I asked before if you thought you were capable of studying medicine. Did you know that the average IQ of university/college students is 120 (1)? Did you further know that the average IQ of medical students is 125 (2)? That’s not substantially different. It doesn’t take smarts, it doesn’t take a genius, to be a doctor. The material in medical school is not challenging or hard to understand. In fact, most of it is widely available on the internet. The only difficulty in medical school is the sheer volume of material, combined with the intense pace that it must be absorbed in. For example, in the space of four weeks, we had to learn everything about the musculoskeletal system. In four weeks we had to learn every muscle, every bone, every tendon, every ligament, what nerves innervate them, their blood supply, and their actions. That’s just the anatomy. We also had to learn the physiology, pathology, microbiology, pharmacology, histology, radiology, clinical presentation, clinical assessment, and more. The struggle that *every* medical student has is in figuring out how to study in order to keep up with the volume of material.

Do you think that you can study medicine, with that pace and that volume of material? Techniques that almost *every* medical student swears by include spaced repetition, mnemonics, and memory palaces. The forgetting curve, as shown in this image, shows how rapidly we forget new information. If you learn new information, within as little as twenty minutes you will have forgotten roughly 40% of it. In under a week you will remember almost none of it.

If, however, you test yourself or review the material after only one day, you will not only reset the forgetting curve, you will also make it shallower. If you repeated this every single day, then after a very short time you will find that you will remember most of the content practically indefinitely. Obviously, reviewing everything, also known as cramming, is not feasible every day. You need to break things down into manageable chunks like flashcards. Realistically though, you only want to review material just as you are getting to the point where you would be starting to forget it. This is where spaced repetition comes in.

In 1988, Ulrich Neisser, stated:
You can get a good deal from rehearsal,
If it just has the proper dispersal.
You would be an ass,
To do it en masse,
Your remembering would turn out much worsal.

Fundamentally, what he said is that cramming doesn’t work for remembering material, but that dispersing the rehearsal and revision out over time does. Or, to put it another way, this.

This is not new information, it has been well known psychologically for centuries, including papers from the 1800’s.

Spaced repetition is where Anki comes in, the spaced repetition flashcard software which most medical students use. It automates the spaced repetition with advanced algorithms. There are even mobile versions of Anki, known as AnkiDroid and AnkiMobile, that sync with the desktop software so you can carry it around in your pocket to do flash cards when you’ve got 30 seconds spare, such as while on the bus, or queueing down at Maccas or while getting a coffee.

I mentioned before that most medical students combine spaced repetition with mnemonics. One example of a mnemonic (at least, the PG version) is represented by velvet: Oh oh oh, to touch and feel very good velvet so heavenly. This represents the 12 cranial nerves: Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Spinal Accessory, Hypoglossal.

I also mentioned memory palaces. This picture is from a service known as SketchyMedical, and this particular picture illustrates the microorganism known as Staphylococcus Aureus, also known as Golden Staph. It might look a little busy, but there are also videos that go along with each picture that work through it piece by piece in order to cover all of the content and form a memorable story. Some quick examples from this picture include the golden staph that Moses holds, linking to the name Golden Staph. The red sea looks solid and is parted because Staph. aureus coagulates blood, or in other words it causes blood to clot. And, it is commonly found in the Nares of the nose, represented by the Sphinx with a missing nose. There are about two dozen more pieces of information clearly visible and memorable in this diagram, making the challenge of remembering the details of this microorganism much easier. And, there is a different picture and story for each clinically relevant microorganism, drug, or pathology.

I have described all of this based on the background of studying Medicine, as that is what I am familiar with, and many of you would be perfectly capable of studying Medicine (or medical science) using spaced repetition, mnemonics, and memory palaces. However, these techniques are not just limited to that field. They work brilliantly for learning languages. They are great for retaining the facts in a history class. Whatever you do, if facts are important, spaced repetition works. I suggest all of you when you next come across new material that would be valuable to remember indefinitely; try out for yourself and see the benefits of mnemonics, memory palaces, and a spaced repetition tool such as Anki.

References

1. Plant, W. T., & Richardson, H. (1958). The IQ of the average college student. Journal of Counseling Psychology, 5(3), 229-231.http://dx.doi.org/10.1037/h0040731
2. Perry, W., & Crean, R. D. (2005). A retrospective review of the neuropsychological test performance of physicians referred for medical infractions. Archives of Clinical Neuropsychology, 20(2), 161-170.https://doi.org/10.1016/j.acn.2004.04.002

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