How to Succeed Notes

Chapter 1 What kind of learner are you?

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Cognitive aspects
o Refers to the way you go about building new information
into memories
o Learn to understand be a deep learner; try to see how the
things you learn can apply
o Memorizing is important for drug names, anatomy
(although not always, its about relationships)
o More on deep learning in chapter 2 (learning knowledge)
and chapter 8 (timetabling and regular study)
Motivation
o What makes you learn? Do you learn for interest or for
grades on exams?
o Some learn because of the fascination, some learn because
of the application
o I am most motivated to learn by:
The application and implication of it in the field I
choose to practice.
Read up on clinical presentations of patients
You can look for case studies or patient videos
Shadow a doctor
Fascination and obsession; a pitfall may be you wont
know when to stop reading on things you cannot
have a PhD on everything in medicine
Tactics to manage this in chapter 2
I like seeing the connections between the things I
learn even if they were taught modules apart
To be an expert in a certain field
External pressure (e.g. they love intimidating
teachers, deadlines)
Create situations like these
Agree deadlines with tutors/accountability
buddy
Note: different topics might have different
motivations for you
You cant only read about conditions that are
seen in patients or youll miss rare ones
If you are 100% exam focused, you miss on
things that are important but not examined
You might want to put a post it up to remind
you of your motivation

Self-regulation of study skills

o Metacognition aware of your own learning; makes you
perform better
o Exercise:
Given a task, think about how you would go about it.
You have a list of complications of diabetes to
learn
You have to memorize a list of drug names for
treating HTN
How do you know that you know enough?
o The problem of not knowing this is learning to much and
running out of time or learning too little
o Exercise: Think for a minute how you know when you have
learnt enough on a topic. What evidence do you use that
you know something? (Personal answer below)
Listening to lectures, transcriptions, and books are
good outlines to know what to learn for exams
But going beyond it is great esp for topics related to
the field you are interested in entering
One way of going beyond is integrating lessons with
previous ones and knowing how it may apply to the
clinics
o Measures to know youve learned enough
Objective: testing yourself from a book of questions,
explaining it to others
Subjective: others telling you that you are
knowledgeable, or you now feel you can understand
what was once complex
Guesstimate: how much hours youve put in or how
many pages youve read (pretty useless students
who use this solely are surprised they fail exams
when theyve read pages and pages)
Conception of Learning
o What is learning for? Is it a passive increase of knowledge
or a way of gaining information that you can use in practice
o Students who try to find personal meaning out of what they
learn achieve deeper learning
o Ask what use is this information what if? Why? Question,
debate, weigh up, different conflicting evidence to make
sense of the information
o Ask questions like: what if diabetes was not a disease of
either you had it or not but a continuum between normal
blood sugar and damagingly high sugar? Why is the
threshold for diagnosing diabetes a fasting sugar of 7
mmol/L and not 7.4?

Learning in Groups
o Has pros and cons
o If you prefer studying alone, you might want to read
Chapter 3 and 4 (clinical and communication skills
learning)
Mood
o Feeling can be intimately involved with thinking
o Passionate and curiosity deeper faster learning
o Angry and frustrated not so much learning
o Do you spend so much time worrying about things that you
dont get them done?
VARK
o Visual diagrams, images, colors
o Aural lectures > books
o Read/Write - books
o Kinesthetic real-life experience, trial and error
Summary

Chapter 2 Learning Knowledge

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Outline
o Key issues and strategies for learning knowledge
o Types of knowledge and tips in learning
o Different learning environments and how best to use them
Key messages
o Learning to learn effectively and efficiently requires
deliberate and reflective effort over time; invest time and
effort and youll carry it for the rest of your life
o No end to what you can learn in medicine learn what is
important
o Only way to survive the load in medical school is through
regular, active, self-directed learning
Start studying to be a doctor (or a specialist) from
week 1 of your course
o Spend time not only thinking about what you learn, but
also how you learn
o Learning in medicine is a lifelong process, you might as
well get the foundations right
How do I know what to learn
o There is no beginning and end in medicine
o Youll need to make some judgments about what you want
and need to learn, but for the rest of your professional life
youll need to make those judgments, so its not a bad
habit to get into.

o Textbooks are handy look through table of contents and

index
Self-directed versus teacher-directed learning
o You need to take control of your own learning
o Keep a notebook or a section of your diary where
you can jot down things you want to look up, and
set aside regular time to do so
These may be things that are important for exams, or
for your practice as a doctor, or they might be things
you find interesting and might make you a more
rounded doctor
Binge learning versus regular learning
o You need to develop a habit of regular self-directed
learning
o You need a deep level of understanding because you wont
be asked simply to regurgitate facts but to apply
knowledge
o You are not studying to pass exams, you are studying to be
a doctor
o You will need a diary and a timetable and you need to plan
regular self-directed learning, some of which will involve
looking up new topics and some of which will involve
reviewing your previous learning to consolidate it into longterm memory. If you get into good habits early on in the
course, they will pay major dividends during the course
and long after.
Lifelong learning and continuing professional development
o No one will tell you what you need to learn
o You will need to know what you do know, to know what you
dont, prioritize what you need to know or what you might
need to know, work out a way of learning it (exotic
conferences are a terrible way of learning), work out a way
of knowing when you know enough on that topic and can
move on
o One of the aims at medical school is to learn how to learn,
and learn to continue to learn, to keep up to date.
Depth versus breadth
o Balancing act
Blooms levels of knowledge
o Knowledge
o Comprehension
o Application
o Analysis
o Synthesis
o Evaluation

The mind, memory, and learning

o Left brain right brain you remember better if you use a lot
of your senses and emotions
o Vaccination theory of memory
Revisit what youve learned before to solidify it in
long term memory (3 days, 3 weeks, 3 months)
Use timetable to mark down review sessions
(perhaps, one evening a week); use this time to
review notes from this week, from 3 weeks ago, and
3 months ago.
o If you use active learning principles (later), you will be
able to review notes quickly and efficiently
Semantic networks
o Memory is linking new learning with your prior knowledge
o Strength of those links will depend on how many times you
use them
o When you learn something new, always build links with
what you already know
Active learning, passive learning
o Before learning
Ask questions (why am I learning this)
Obtain an overview (table of contents, or headings)
Write down what you already know about it
Key questions
o During learning
Notes: dont write it word for word
See where your learning links in with other things
o After learning
Tidy up notes
Answer questions
Can you explain it to others?
o Learning by doing
Making Notes
o Key words
o SQ3R
o Cornell method of taking notes
o Concept mapping
o Mind Maps
o Cue cards
o Tables
o The right tools for the right job
Learning environments
o Learning from lectures
Sit where there is least distraction

Note what the lecturer said to remember,

highlighted, in summary
After the lecture, try to tidy up notes and find out
how it fits with previous learning
Bad lecturer: find objectives and find a book to read
on it
o Learning from books
Be attentive, minimize distractions
o Learning from the internet
o Finding that review article

Chapter 3 Learning Clinical Skill

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Outline
o Concerns examination and practical skills
o How to learn them from books, from simulation, and from
patients
o How to make the most out of tutors and when tutors are
not around
o Feedback
Intro
o Clinical skills are what make doctors
o Without skills, you cannot proceed with investigation and
treatment
Cardiopulmonary resuscitation, taking blood,
inserting drips
o Without communication skills, you cannot explain to the
patient treatment options or breaking bad news
o Knowing how to do the skill, practice (hours and hours of
deliberate, reflective practice) and receive feedback
o Requires self-directed learning; seek learning opportunities
and be enthusiastic but not too eager
How do I know what to learn
o Get a published list of the skills you need to learn (to do, or
just to know how to explain)
MacLeods and Hutchinsons
o Forgetting the checklist for a while, make a list of what you
think you need to know by the end of your medical
education in medical school.
Structure in a way that makes sense to you (body
system, by year of study or level of complexity)
Keep the list with you, go through it regularly,
annotate and add to it this could be the first section
in your clinical skills folder
Level of competence

o Benners model of levels of achievement

Novice
Advanced beginner
Competent
Proficient
Expert
o A model for the self-directed learning of clinical skills
Evans-Brown model theory, practice, feedback
o Building a theoretical framework on how to perform a skill
3 parts of knowledge to perform a skill
Sensorimotor the trick, where you put your
hands when
Understanding underlying principles,
anatomy, phys etc.
Clinical reasoning making sense of the finding
to reach a diagnosis
You can make a table using the three elements above
as column titles, you can add feedback as the fourth
column
Practice
o Simulation skills lab, family members, flatmates,
classmates
o Practice with patients
o Asking patients for consent
BMA English and Sommerville
Basic minimum:
Give your name (first and family name) and
role
Explain what you would like to do
Explain that the interview is for your education
only
Explain refusal will not affect the patients
treatment in any way
Explain confidentiality issues e.g. where the
information will go, who will see it
Say how long it will take
Offer to come back later if the patient is tired,
unwell or expecting visitors
Hello, my name is John Smith, Im a 3rd year
medical student attached to your consultant,
Dr. Jones. I am currently learning how to
examine the pulses in the feet and I was
wondering if I might examine your feet? It will
take no more than 2 minutes and will just

involve me touching your feet to find where the

pulses are it shouldnt be painful or anything.
Its just for my learning so no problem if you
say no.
It is important to tell the patient when interviewing
them that the information may be shared with the
rest of the health care team.

Feedback
o It is hard to see what you are doing when you are doing it
o Tutors, experts
o You need to act on feedback too (Chapter 4)
o
Learning in a clinical learning environment
o The clinics, wards, surgical theater can be a pretty
unstructured place for practicing or learning
o Approach to patients
Dress smartly and modestly (No trainers, jeans, caps)
Cleaned and groomed
Be aware of infection control (short clean fingernails,
hand washing, dont drape tie or stethoscope
anywhere, sleeves rolled up)
Consider your nonverbal: dont look uninterested, no
chewing gum, pay attention
Professional language (avoid slang or street
language)
o Making the most of your tutors
Learn how to engage your tutors (consultants)
because they like teaching those who are interested
and enthusiastic
o DONT
Sit in the corner looking bored
Wait for teaching to happen Go find it
Sneak off because nothings happening
Yawn and open a book halfway through clinic
Assume only doctors are useful teachers nurses,
pharmacists, ward clerks, etc.
Assume that only the team you are attached to are
allowed to teach you
Refuse teaching because it is time to go home
o DO
Look awake and attentive
Dress smartly

Make the first move. Can I watch you do the LP? I

was reading about Xrays last night, can you tell me
what is on this one?
Accept rejection: Im far too busy to teach you right
now? should get a reply Oh, of course, Im sorry is
there anything I can do to help? Like take forms to
Xray or something?
Ask for specific, achievable feedback can you
watch me as I examine Mrs. Patel? Is less likely to get
an enthusiastic response than can you watch me
while I do a 5-minute cardiovascular exam on Mrs.
Jones, and let me know if you think Im doing it
right?
the learning opportunities
Drug charts
Go around the ward look at drug charts and look at
drugs you dont know
Ask for a blank drug chart and practice writing up
drugs for management of different diseases. Ask for
comments.
Drug rounds
Offer to help when nurses dispense drugs to patients
Practical skills
BP, pulse, temp
Physiotherapy
Radiology
Read about interpreting radiographs
Ask if you can tag along and watch radiologists
reading radiographs
Others (OPD, OR)

Spot
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Chapter 4 Learning Clinical Communication Skills