Note: This article was originally written and posted by me on prep4usmle.com. It talks about how to increase our ability to acquire knowledge. Part 1 is on How we learn and Part 2 is on how to increase our reading speed which is posted here. You can access the original post in prep4usmle here.
We’ve discussed the concept of Mastery Know and Familiar in our Knowledge level and how this will impact our performance in the exam. Continuing our KA discussion, we will discuss 2 topics that is important in increasing our ability to acquire knowledge.
First we will discuss the difference between the way children and young adults learn versus the way adults (those in their late 20’s and beyond) learn. Most people acquire their learning methods while in elem. and high school and continue using the same methods even when they are no longer applicable without some modification.
Second, we will discuss speed reading. Increasing reading speeds 10 to 20 times faster may take years and is impractical for our purposes. However, increasing reading speed by 25, 50 maybe even 100% is achievable within a few weeks and just may be what most of us need to be able to acquire knowledge faster and go through questions faster and fare better in this examination.
When I was in Med School we had a subject called Pedagogy or the science of teaching or learning. It was one of the little 3, Pedagogy, research methods and management which most of my classmates look with disdain and did not take seriously because it is not “Medicine”. You see our school wanted us not just to be doctors but also educators, researchers and administrators. In my case, I was fascinated enough with the topics to go beyond what was taught and do my own research, even after graduation. I came upon a discipline called Andragogy, which is a subdiscipline under pedagogy. Pedagogy, root word “Pedia” concerns itself more with how children and younger people learn, while Andragogy root word “Andro” (for Androgens) meaning Man or Adult, concerns itself with how older people acquire knowledge.
To understand why children and adults learn differently, we have to go back to basic developmental neurophysiology. I have not found any book which effectively discusses this topic, however, what I know of it, I’ve gathered by reading various Journals mostly in Science and Scientific American. Some concepts may even be found in Guyton. I’ll present this in shortened form as a whole treatise may be a book by itself.
How do we learn and how does it get stored in our brains? One theory is that when we learn something new, a neural connection is formed between an axon and dendrite which represents that information. When the learning is repeated, the connection is strengthened and we tend to remember that information longer. Therefore, repeated reinforcement will lead to more permanent learning and that explains why we were taught our ABC’s by repeated reading. However, some believed that continued repetition increases the number of neural connection we create and that is the basis for stronger retention of the information. My own thinking is that it is a little bit of both.
From birth to about 10 years of age, our nervous system is an empty page with tremendous potential for learning. There is very little neural connections between axons and dendrites. As the child grows, neural connections are formed and with repetitive learning, neural connections are strengthened and duplicated. However, after the age of 10 or thereabouts, the neural growth pattern changes. Strong neural connections are strengthened further while weak connections are eliminated ruthlessly. This explains why children have the infinite capacity to learn but lacks mastery and tends to be clumsier, while adults lost this capacity to learn, but what they know, they can master to the fullest. This applies to all types of learning including mental, physical etc.
By the time we hit our 20’s the process of specialization is almost over. Most of us can still learn by just mere repetition, but usually slower and with more effort than those who are younger. This also explains the rather curious finding that Japanese children who never learned to speak another language until after 10 always have extreme difficulty with their l pronouncing them as r. This is because there is no l in Japanese.
Most people still try to learn new things by repetition, but keeps on wondering why they keep on having problems retaining them. This is because adults have lost the capacity to learn by pure repetition. What they already know they can strengthen their retention by repetition. What they do not know, they will have a hard time retaining by pure repetition. This becomes more so as they grow older.
So how do adults learn? By Association. Since Adults cannot form new neural connection, They have to utilize a previous neural connection to build a new one. This is helped a lot by the development of abstract reasoning ability in adults. This abiltiy helps to learn by association. After that, mastering is by just pure repetition
Children can learn unrelated information by pure repetition. When they learn a new information that links 2 previously unrelated information, they can just correlate and continue. This is akin to cementing a driveway. You can cement different parts of a driveway and connect them later.
Adults cannot learn unrelated information. They need to relate that information to something they already know before they can learn it. It is akin to constructing a building. If you have built the first floor, you cannot build the fifth floor until you have built the second, third and fourth floor first.
The biochemistry and genetics section in Kaplan Notes is great. Except that when I first read it, it looks greek to me (If you’re greek, it probably looks chinese to you!) Anyway, so I decided to use Lippincott instead. After finishing Lippincott, reading Kaplan was a revelation. There were many concepts you could not master with Lippincott alone, but without Lippincott, I could never learn the concepts in Kaplan Notes let alone master them.
I have a 1996 edition of NMS Genetics, which I read. About 90% didn’t show up in the exam and I knew this. However, I needed about 50% of the material in the book to understand the 10% that is tested in the boards. It also helped me understand the genetics section of Kaplan Notes better.
So what implication does it have on our learning process?
1. If you find yourself having a hard time retaining some information, it maybe because you are trying to memorize information unrelated to what you already know. The solution may be to consult a more basic text so the information could be more readily retained. After that mastery is by simple repetition.
2. At times, you might have to learn board-irrelevant information to understand concepts tested by the board. Do not hesitate to do so if you think that this is the case.
3. When like me, you are faced with a lot of new concepts that you do not know, do not start your study by trying to master or memorize anything. Start reading first to understand the concepts. If you hit the fifth floor in your reading, continue and by the time you finish, you’ve already found your second, third and fourth floor that the fifth floor becomes extremely understandable and masterable already.
4. This is also the reason why it is harder to increase mastery of a concept by doing q’s alone especially if the problem is KA. The information is isolated and may be unrelated to what you already know and therefore retention is harder without associating it with a whole concept.
5. It is easier to learn different interrelated concepts as a group rather than learning this individually. Although sometimes this is not the way it should be recalled. For example, it is easier learning drugs in groups and as I said previously by ‘mastering the prototype, knowing impt. derivatives and being familiar with the more obscure derivatives” But recalling them, esp. in relation to the exam requires you more often to do it on a per drug basis rather than by class, therefore a good recall tool is flashcards. The same can be said of Microbiology. Learn it using books, practice recall using flashcards.
If you discover or know some things based on this learning concept, feel free to give examples and share your experience to help others.