I had an interesting discussion on effective learning with one of my students recently. It looks like some of the teaching methods in medical school have changed since I was a student, but they still make future doctors sit through hours-long lectures. Really? In the era of easily available ebooks and interactive textbooks, free video lectures from the best in the world, games simulating clinical scenarios, and the like? In the times where it is clear that our attention span is at the best 20-30 minutes? I’m surprised that the attendance at the lecture is 30%. I’m surprised that anyone is there at all!

On the other hand, with all the knowledge about how people learn, students’ preferred method for preparing for an exam is still cramming.

I hate cramming. Not that I never did it – I did! I still remember the songs I wrote to remember topography of some of the cranial nerves.

The problem with cramming/memorisation/rote learning is that although it may work for an exam next day, its effects don’t last long. It’s not an effective learning strategy. And this is the reason why:

So what’s best for long-term learning? How do you actually ace your exams without cramming?

For effective learning to happen, we need these four elements nicely aligned:

1. Attention and Focus:

Attention is like a filter (not quite as this article shows, but this is a good enough metaphor) that limits the amount of information that enters or remains in our memory (storage). It is the amount of time we can concentrate on a task without becoming distracted. It has its own limitations, mainly its span.

Apparently, studies show that we can sustain our immediate attention for as little as 8 seconds (down from 12s in 2000). It’s enough to remember 7 +/- 2 numbers/items (e.g. a 7-digit phone number.

Even if we consciously try to keep our attention up, it doesn’t last very long. Our selective, sustained attention is somewhere around 20 minutes, but it looks like after 10 minutes our attention rates drop.

One of the keys to better learning is your ability to keep your attention on the stuff you are trying to learn – in other words your Focus.

If you’re not focused on whatever it is you are trying to learn, you can cram away all night and all day and it will not stick. Your focus filters the info in – just like a coffee filter filters coffee into the jug underneath it. If the filter is clogged, too narrow, or if you keep shifting it from one container to another – not much is going to get into your jug, right?

Clear your focus, get rid of distractions, optimise your body, your mind and your environment for more effective learning, particularly, if you want to concentrate on studies for long hours.

2. Connections / Associations / Consolidation

This part of the memory formation in learning is widely discussed by many people – specialists and layman ‘practitioners’ alike, and various people may call it various ways: Deep Processing, chunking, Creating a construct

In a nutshell, in order to learn more effectively, you need to organise information into meaningful groups: chunks, concepts, whatever it is called. These pieces of organised and connected information can vary in size and complexity. The more connections between the information we are trying to learn and what we already know, the better.

My metaphor for this part of learning is from the construction industry. You can build a house (knowledge) brick-by-brick (fact-by-fact), or by using pre-fabricated modules (chunks) that include various pieces of masonry (information) already bound (connected) together.

Which one you’d rather be involved?

(On the other hand, you need to put this pre-fab/chunk together first – more about it soon)

3. Emotions

Emotions affect our cognitive processes, and learning in particular, in a variety of ways. The effects vary depending on the type of emotions (positive vs negative vs stress) and the step in the learning process (encoding/storage/retrieval). But overall, an emotional stimulus affects our ability to pay attention. Why? Becuase it immediately becomes the focus of our attention, narrowing our ability to see/hear/feel/process anything else.

Emotions experienced during learning and retrieval, negative and positive, consolidate into our long-term memory (storage) more efficiently than non-emotional information. Moreover, a recent study shows that people with severe memory impairment, such as in Alzheimer’s, can be affected by emotions for a period of time, even though they have forgotten the content/event that have made them feel like that in the first place.

Yes, emotions, used well, can boost effective learning.

At the extreme is stress – we all remember stressful events very well, but is stress good for learning? John Medina, author of Bran Rules is clear: we remember stressful situations, all right, and stress in small intensity may boost our performance. But long-term and too much of stress kills our ability to learn.

4. Spaced repetition

In order to really move the newly acquired knowledge from short-term memory into the long-term storage, we need to beat the forgetting curve pictured above.

And we can do it by spacing the repetition of the learning material in certain intervals. Art Kohn suggest a 2+2+2 memory boosters to induce deeper processing. Revise the learnt material 2 days/2 weeks and 2 months after the initial ‘session’.

There is a whole industry built on the art and science of spaced repetition. I’ve mastered two languages using spaced repetition methods and I can’t praise it enough.

Unfortunately, there are still things we may need to simply memorise, like multiplication tables, historical dates, names – and other so-called arbitrary information. But if you have some conceptual knowledge to master, such as human physiology, the nitty-gritty of income statement, or how a car engine works – these four elements are key to effective learning.