Teaching Resources · Study Skills
A Student Guide

Before you attend a lecture.

What to do before, during and after the hour — and why each step is worth the time
Husain Alkhaldy · King Khalid University · Abha, Saudi Arabia
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Companion guide: Solving Clinical Science MCQs.

1. Before the lecture

Find the objectives for the session and read them before you go. They are usually a short list. Read them slowly enough to see which ones you could already answer and which ones mean nothing to you yet.

Then give the topic ten or fifteen minutes. Skim the chapter headings, or a summary, or your notes from the session that led into this one. You are not learning the material at this stage. You are arriving with a shape in your head that the hour can fill in.

Write down two or three questions you want answered by the end. Take them in with you. A question you have already asked yourself is much easier to notice being answered.

If you have five minutes and not fifteen

Read the objectives and write one question. Even that much changes the hour: you go in listening for something rather than listening to everything.

2. During the lecture

Do not try to write down everything that is said. Copying words takes most of your attention, and attention is the thing you need for understanding. Working memory is sharply limited, and effort spent on anything that is not building understanding is capacity you no longer have for making sense of the material (van Merriënboer & Sweller, 2010).

So write less, and write it in your own words. Putting an idea into your own phrasing is itself a piece of understanding; copying a sentence is not. Notes are worth more when you rephrase than when you transcribe, though the evidence on handwriting versus typing is genuinely unsettled — use whichever you are faster with.

Mark what you did not follow. A question mark in the margin, a circled term, one line at the foot of the page. Those marks are the most useful thing you carry out of the room, because they say exactly where your work is.

Ask while you can. If the lecturer takes questions, ask about one of your marks. If there is no time, ask afterwards or send it by email.

What a mark looks like
? — lost the thread at the second step “compensated” — what does this mean here? diagram on the third slide — copy it later, did not follow it live

3. After the lecture

Close the notes and the slides. Then write down, or say out loud, everything you can remember from the session. Open the notes afterwards and see what you missed. The work is in pulling the material out of your own head; the checking only shows you where the gaps are.

Do this on the same day if you can, while the session is still close to hand. Ten minutes is enough.

Then come back to it. Look again after a few days, then again after a week or two. The same total time, spread over several separate occasions, gives you more than one long sitting does.

4. Why this works

Spaced review beats one long sitting

Cepeda and colleagues pooled 317 experiments and 839 assessments and found that reviewing the same material on several separated occasions beats the same total time in one block. In medical students specifically, Kerfoot and colleagues randomised which urology topics each student received spaced email questions on, so each student’s spaced topics could be compared with their own un-spaced ones. Scores on the trial’s own 28-item test were higher for the spaced topics (p < 0.001). That test was built for the study, not the school’s examination.

Testing yourself beats re-reading

Larsen, Butler and Roediger assigned paediatric and emergency medicine residents to be tested on one topic and to restudy another, counterbalanced. More than six months later, the tested topics scored 39% and the restudied topics 26%.

Read those two numbers honestly. Both are low. Retrieval practice changes how much survives; it does not make the material permanent, and nothing here removes the need to go back to the topic. It is still the better use of the same hour.

The medical trial sits on a wider literature. Roediger and Karpicke reviewed the laboratory work on the testing effect and made the case that a test is not only a way of measuring what you know — it is one of the better ways of learning the material in the first place.

Working memory is the limit

Cognitive load theory is the reason for the advice about note-taking. Working memory is small, so work that does not build understanding spends capacity you need for the work that does. Copying words down is that kind of work. The preview earns its place the same way: it is easier to follow something when you already know the shape of it.

Dunlosky and colleagues reviewed ten study techniques commonly recommended to students and rated only two as high utility: distributed practice and practice testing. Those are the two this guide is built on — spacing your review, and testing yourself instead of re-reading.

References

Cepeda NJ, Pashler H, Vul E, Wixted JT, Rohrer D. Distributed practice in verbal recall tasks: a review and quantitative synthesis. Psychological Bulletin 2006;132(3):354–380.

Kerfoot BP, DeWolf WC, Masser BA, Church PA, Federman DD. Spaced education improves the retention of clinical knowledge by medical students: a randomised controlled trial. Medical Education 2007;41(1):23–31.

Larsen DP, Butler AC, Roediger HL. Repeated testing improves long-term retention relative to repeated study: a randomised controlled trial. Medical Education 2009;43(12):1174–1181.

Roediger HL, Karpicke JD. The power of testing memory: basic research and implications for educational practice. Perspectives on Psychological Science 2006;1(3):181–210.

van Merriënboer JJG, Sweller J. Cognitive load theory in health professional education: design principles and strategies. Medical Education 2010;44(1):85–93.

Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving students’ learning with effective learning techniques: promising directions from cognitive and educational psychology. Psychological Science in the Public Interest 2013;14(1):4–58.