How to Triage All That Into Your Brain
When students look at all of the lecture notes, PowerPoint slides, journal articles and textbook assignments for their courses, it can hit them like a tidal wave or a major earthquake. Whatever the disaster, it can be overwhelming. But by remaining cool, calm and collected, as all medical students have trained themselves to be by now, they can look at this work load and figure out how to tackle it just like they would in a situation after an accident with multiple injuries or after any incident creating multiple admissions.
Just as in the hospital…
First - look at each assignment to get a feel for the overall situation, and then begin making decisions. It’s a good idea to get an overarching feel for what you are dealing with by first breaking down your week’s assignments into segments and just reading over the main headings and subheadings in your textbooks to see what you are supposed to cover. You may find that you have a good foundation for a lot of the material for that week – or not. Then you can plan accordingly.
Second - scan the material closer to get a better feel for the overlap among the resources and determine if all the readings are necessary. If they overlap, then find a friend and divide them and each person read the assignment from a different resource. Briefly outline that week’s assignment and see how much they differ in terms of information. Together decide what is essential and non-essential (see Triage Below). Or get together and go over a topic each from the opposite book and trade what is different or missing from each resource.
Third – when you scan the material, do it to figure out what the larger picture is. You must know what the bigger picture is. What is the major reason for your Triage in the first place: to fit the information into its proper place and make decisions about what to do with it. Looking at the overall chapter (or presentation, or scribe) first helps you do this. Look at the objectives at the beginning, summary at the end of the chapter, and any questions at the end the chapter. These all provide big hints as to the bigger, overarching picture and to what will show up on your exam in some form or another.
Triage separates your massive amount of information into four groups:
The information that you already know or is beyond knowing and can be eliminated from the need-to-know list – not necessary for survival.
The information that can and should be learned by immediate uploading - is necessary for future survival (Future survival definition: for building future information and for passing the upcoming examination.)
The information is important but its transport into the brain can be delayed because later treatment is best for survival – that is best learned a few days before the exam because it is mostly memorization that does not rely on understanding. It is information that does not rely on understanding other concepts. You must be clear in making these decisions and as in a clinical situation, you must not put off treating too many conditions as the entire system will suffer since all the systems work together for survival.
The information with minor impact, that needs less attention and is not necessary for survival, but would be good for impressing your classmates or attending. This is information that might show up in one question, but your survival is much better spent on taking care of learning material that is essential to survival on the examination. Learn that material well and it will make up for the minor impact information.
Fifth - To take the triage metaphor further, when you are working under time limits and stressful conditions, it would be wise to focus first on the physiology of the organ system first. If you understand the physiology of the organ system and how it works under normal conditions, then when processes are disrupted, you will be able to reason through the pathology and pharmacology information much easier.
So… Physiology first, then pathology and pharmacology are built on top of that.
How to Know What is Important
Just in case you are lost as to how to make the above decisions in the triage list, this may help: get one assigned textbook and go through all of the chapter summaries and ask yourself, “What I’m supposed to know from that chapter?” Try to come up with 2-3 overarching themes. Now go through each chapter and learn anything bolded or italicized, as well as anything listed in a series; that is, with a “1, 2, 3” or “A, B, C” behind it.
Textbooks will give you clues as to what is important by going over a concept in detail in the text and then also creating a chart, diagram or graph to further explain the idea, facts, or information that is important to know. This repetition is a clue that this information is important.
Another clue as to what is important is if the information is included in a review book or shows up in more than one class lecture/ class scribes or has an entire slide devoted to it during a presentation.
Now Triage into Your Brain
1. Filter out new from old information - Determine the information that you have learned before in another course or have heard before from TV, journal articles, etc. and review it quickly. Highlight in the margin, or mark with a check mark, what is new information that you need to learn versus what you already know. Many times students will spend just as much time relearning material on what they already know as new information because they dislike learning something new – it takes more effort and energy and is less empowering. They enjoy relearning because it is easier and makes them feel like they are accomplishing more – when they are actually wasting time. (Why give a patient blood when they already have plenty? It’s overkill. Move on to what the real problem is.)
2. Find a way to develop shorthand notes for the essential new material identified following the guidelines above. Do this as actively or interactively as possible (versus passively where you are just copying information from the book). Organizing notes and writing information in your own words or making a chart or diagram is the best way to learn information/concepts/processes and how facts or ideas link together. Stop complaining that this is time consuming… so is surgery!!! But in the end, isn’t it the preferred solution to a critical, life-threatening health issue? Once you take the plunge and you’ve done it – then all you have to do is go back for a check- up every once in a while to make sure you’re doing well.
3. Simplify what you need to learn. For the brave…If you have a list of 30 drugs or bugs to learn in the same category and you are running out of time, try going to a board review book for a chart that simplifies what you need to learn. The review book will narrow the list to the most important drugs or bugs in that category and what is essential to know about them. Focus on knowing this information really, really well. Many students that honor classes will take this risk by taking a hit on missing one “zebra” question so they don’t spend a lot of time on that less essential information. This strategy is not for every student. However, for the overwhelmed or for those who have struggled and are looking for a possible alternative, they might try this for a few topics and see how it turns out on one exam before expanding this full on.
4. Find a more meaningful method for learning complex topics. For the truly dense or overly difficult topics you just can’t seem to grasp, it is time to get with a couple of classmates and discuss it. Read the material first, take notes, go over your review book, then get together. You might also turn to looking for a video lecture on the topic. Believe it or not, there are tons out there on YouTube, for purchase individually, and on medical student websites. Hearing the information from another point of view can help you understand the material when you couldn’t understand it from the lecturer at your home institution. Just be sure that you go over the material that is assigned for your class. The most important message here is that you are turning to a more active, meaningful way to learn the material than continuing to sit in front of a book and struggle trying to find meaning.