How to Study Medicine

HOW TO STUDY MEDICINE

Reynaldo O. Joson, M.D.

*Why learn how to study medicine effectively and efficiently?

You have to learn how to study medicine effectively and efficiently in order to:

1. Facilitate the achievement of your goal to become a physician.

1.1 Be able to pass certifying examinations.

1.2 Be able to master the competencies expected of a physician.

2. Cope up with the enormous scope of the medical profession.

2.1 Be able to develop a framework to facilitate your learning of the vast scope of medicine during your training proper.

2.2 Be able to use a framework to learn whatever is necessary to practice the medical profession effectively and efficiently throughout your life.

2.3 Be able to develop a competency of self-directed learning considering that medicine is a life-time of studying and learning and considering that no teacher can teach you everything.

*What is a self-directed learner or what is self-directed learning?

A self-directed learner is someone, who with or without the help of others,

diagnoses his own learning needs;

sets relevant, feasible, and measurable learning objectives;

determines generally acceptable standards or criteria which will be applied to assess whether learning has in fact occurred as planned; and finally,

formulates a coherent learning agreement or personal curriculum for the course.

*What is the importance of self-directed learning?

It is impossible for the teacher to teach everything during a formal teaching session.

It is impossible for the student to learn everything during a formal learning session.

There is always still a lot of things the student has to learn after a formal course.

The only way to self-improvement, updating competencies, and solving future problems is self-directed learning.

The student should acquire self-directed learning skills while he is still in school.

For the teacher, the final gauge of accomplishment or end-point of teaching is whether he has helped develop his student's self-directed learning skills or not. If not, his job is not yet done.

*What are the steps in accomplishing or promoting self-directed learning?

1. Doing a situational analysis.

Facilitator helps students develop the skills and insights they need to analyze their own situations critically. This may be done by the student himself, if he knows how to.

Compiling a "competency profile".

"What are the competencies expected of me when I become a physician in the community?"

"What knowledge, attitude, and skills do I need in order to be an effective, efficient, and humane physician in the community?"

Defining professional competencies is essential for the learner to make decisions about what should be learned and for the learner to assess how effective his learning has been.

The facilitator helps the learners define the specific competencies they will require to function effectively after the course. This may be done by the student himself if he knows how to.

After compiling a competency profile, the learner does a self-analysis or self-assessment. Here, he identifies his learning needs, what he doesn't know and what he needs to learn.

2. Formulating learning objectives.

3. Drafting a learning plan.

3.1 Learning objectives

3.2 Learning strategies/activities/resources to achieve objectives

3.3 Methods of assessment and evaluation indicators

3.4 Timetable

4. Implementing the learning plan.

5. Evaluating the outcome.

6. Improving.

*Can you see the processes of management in self-directed learning?

Planning

Diagnosis of learning needs

Formulation of learning objectives

Formulation of learning strategies and activities (learning program)

Formulation of methods of assessment and evaluation indicators

Implementation

Evaluation

Improvement

*What are effective and efficient ways of learning medicine?

I. First, you must always have a learning plan.

This learning plan can originate from you as part of your self-directed learning activity. Or, it may be influenced or partly dictated by your faculty facilitator.

The learning plan must contain the following elements:

- Specific learning objectives

- Learning strategies, activities, resources

- Timetable

- Methods of assessment

- Evaluation indicators

1. The learning objectives must be specific, measurable, attainable, realistic (relevant), and time-bound (SMART). These objectives serve as the basis for the learning activities and evaluation procedures. They also imply prioritization in consideration of importance, relevance, and time constraint.

2. The learning strategies, activities, and resources must be such that they facilitate attainment of your learning objectives in the most effective and efficient way possible.

2.1 Efficiency means attainment of your learning objectives with the least amount of resources or at the least expenditure of time and cost. This implies the use of skills in prioritization and resource (especially, time) management.

2.2 Effectiveness means attainment of your learning objectives.

2.2.1 Learning, which is your generic goal, is defined as a change in behavior, disposition, performance, or capability which persists over a period of time. It can also be defined as accomplishment of all the specified learning objectives. In practice, however, this latter definition has the shortcoming of lack of assurance of sustainability of change.

2.2.2 The most effective way of learning is when the students are actively involved in the learning process.

2.2.2.1 Take a look at the diagram below:

2.2.2.2 Examples of active learning activities are:

- Writing

- Drawing

- Performing

- Role playing

- Discussing

- Debating

- Accomplishing projects

2.2.3 Other ways of effective learning are:

- Learning in the functional context such as:

Problem-based learning

Community-based learning

- Using a framework:

3. The timetable should be given emphasis not only to set the time that learning should be completed but also as a training in time management.

4. The methods of assessment should be such that they are valid, reliable, and practical.

4.1 Validity means the methods of assessment are able to measure accurately what they are supposed to measure. In practice, the things to measure are the learning objectives, whether they are attained or not.

4.2 Reliability means the consistency with which a method of assessment measures what it is supposed to measure.

4.3 Practicality means the most effective and the most feasible method of assessment in the presence of constraints such as manpower, time, and cost.

4.4 The general methods of assessment are the written, oral, and practical examinations.

5. Evaluation indicators must be specific, the presence of which will clearly indicate that you have learned or you have achieved your learning objectives or vice versa.

5.1 Evaluation indicators usually come in the form of passing a test either administered by yourself or by other people.

II. After drafting your learning plan, the next thing you must do is to implement it.

1. In implementing, you must as much as possible stick to the plan. You can only do some changes if you think they will be of benefit to your learning goal.

2. In implementing, time management should be emphasized.

3. Hardwork, discipline, and sacrifices are some traits that will contribute to successful attainment of the learning goal.

III. After the implementation of the learning plan, the next step is evaluation, to determine whether you have learned or not, whether you have achieved your goals or objectives or not.

IV. After the evaluation, you determine what improvements you need to do. These improvements will serve as your new learning needs. With these learning needs, you formulate another learning plan.

*There is really no end to learning as long as you are still alive and willing to learn.

*How do you prepare for an examination?

There are four general and basic ways of preparing for an examination. These are, namely:

1. Know the objective of the examination.

Is it for diagnosis?

Is it for certification?

2. Know the scope of the examination. If this is not possible, know at least the topics or subjects to be covered in the examination. Prepare for it by mastering the content based on the scope, topics, and subjects.

3. Know the type of examination to be given and prepare for it (testwiseness).

4. Have drills and exercises before the actual examination.

*How to pass certifying written examinations like the Philippine Board of Medicine examinations?

Situational Analysis

1st problem - Anything goes!

Nobody knows what will be given in the exams.

Everything depends on the examination committee and its members.

The examiners are "variable" in knowledge, attitude, and skills in test construction and in assessment.

If only you know what questions will be given, preparation for the exam will be easier.

Do not bank on a leak. It may not occur at all or if it does, it may not reach you.

Go for a legal way of preparation!

2nd problem - No standard learning or review materials!

Objective

Despite the problems you have on hand, you must by all means pass the exam.

Only you can take and pass the exam.

Your teacher can only coach you on how to prepare and how to pass the exam.

Your teacher can

advise you on how to prepare for the exam (books to read, time management, etc.) on areas to put emphasis on in your review based on his experience with the past exams, examiners, current trends in medicine

teach you on testwiseness

how to answer test questions

fill in your knowledge gaps.

You as the examinee must do all of the struggling and hard work, if you really want to pass the exam.

General strategies in preparing

1. Be overprepared than underprepared.

2. Map out your plans and strategies.

2.1 Try to know the examination as well as the examiners if you can

2.1.1 Get hold of old examinations.

2.1.2 Ask around (past examinees and examiners).

2.2 Read, analyze, comprehend, and memorize.

2.2.1 Textbooks

2.2.2 Reviewers

2.3 Prepare for the examinations.

2.3.1 Have drills and exercises.

How to take the written examinations

1. Make sure you understand the question (stem) before you proceed to the responses or options.

If the stem is not easy to understand, go over the options rapidly to get clues on what the question wants. Then, go back to the stem and then, back to the options.

2. Consider each option in terms of

T (true) or F (false)

x (least likely), / (possible), // (most likely)

or ? (don't know)

whichever is applicable.

Note: If allowed, use pencil in your analysis and then erase the marks you made when you don't need them anymore.

3. Weigh the probability of each option to be the correct answer. Look for clue in the question (see testwiseness).

4. Choose the answer which will most likely be the correct answer. Don't waste your time trying to be absolutely certain with your answer. If you do so, you may not finish your exam. You may panic later on when the proctor will announce "last ten minutes" and you still have 50 questions or so to answer.

5. Don't spend too long a time on an option or a question.

Decide or guess for an answer for difficult questions.

Don't leave any question unanswered once you pass through it. You can place a (?) mark on questions you want to go back to after you finish with the last item in the test.

6. Testwiseness tips:

If you are not sure of the answer,

consider an option most likely to be true or correct,

- if you find the words "sometimes, maybe, probably".

- if the option is long.

consider an option most likely to be incorrect,

- if you find the word "never".

if the stem because of its grammar calls for one answer in multiple correct response question, choose no. 4 option or a "D" answer.

if the options contain (a) and (b) or (a), (b), and (c) as possible answers, in a choose the best answer question, concentrate on these options rather than on the single option answers. The same thing holds true for questions with "all of the above" option.

if the options contain a "none of the above", chances are this is not the right answer, unless you are definite that the other options are not the correct responses or answers. So, concentrate on the specific responses and choose one.

NOTE: THE WRITTEN EXAM IS ESSENTIALLY A GUESSING GAME!

ANALYZE EACH OPTION AND COME OUT WITH AN ANSWER WHICH YOU THINK WILL MOST LIKELY BE CORRECT.

YOU CAN NEVER BE ABSOLUTELY CERTAIN WITH AN ANSWER.

SO DON'T WASTE YOUR TIME TRYING TO BE ABSOLUTELY CERTAIN WITH ANY OF YOUR ANSWER.

How to take an oral examination

Tips:

1. Be at ease.

2. Understand the question.

3. Answer the question direct to the point.

4. Be clear in your answer.

5. Be logical in your answer.

6. Be systematic in your answer.

7. Be brief and concise in your answer.

8. Be courteous. Show respect to the examiner.

9. If you don't know, say you don't know.

FRAMEWORK/FOUNDATION OF HOW TO STUDY

Reynaldo O. Joson, M.D.

ROJ@17apr5;17apr12