Hispanic and Native American Center of Excellence -

1. Set realistic learning goals. These goals serve as the driving force “to generate and maintain the motivation, thoughts, and behaviors” * necessary to succeed. Set and use long-term occupational goals (you want to be a doctor) and short-term learning goals (you want to understand this new material).

· Know yourself as a learner (learning preferences, talents, best times of day to study, ability to match study skills to learning task); this knowledge helps you set realistic yet challenging learning goals.

· Knowing a variety of study skills and learning strategies and how to use them.

· Knowing the contexts in which what is being learned can be used now or in the future.

· organize and integrate new information with existing knowledge, or reorganize existing knowledge to fit the new understanding and information.

* Adapted from Weinstein, C.E. (1994) “Students at risk for academic failure: Learning to Learn classes,”
Prichard, K.W. (1994), p.376+

Survey, Question, Read, Recall, Review: The "foundation approach" also known as SQ3R is outlined below. (O'Neil & Speilberger, 1979)

A. Survey--the text chapter by reading the headings, sub-headings, and boldface print; then based on this survey of the text...

B. Develop questions--write out questions remaining concerning the text material.

Both Primary and secondary support strategies are sometimes needed. Primary strategies are those that you use to learn the material directly; support strategies are used to keep focused.

A. Strategies for comprehension and retention. To help you reorganize, integrate, and elaborate the new material:

q repeat , mentally process the same material more than once using active recall, also process the information by putting the material into an alternate form such as your own words, or another symbol system like concept maps.

Go back to material and correct your understanding, expand on the recalled material, store important information, ask and answer specific questions in 3 categories:

→Identify errors and determine underlying causes, so that you can modify study methods.

How to move all this new material into long-term memory so you can find it again.

1. Goal Setting and scheduling: Set daily, weekly, and semester goals, you need to schedule time to study, review, and plan, especially long term projects.

2. Concentration management: Two problem sources are attitude problems and problems coping with distractions:

3. Use your learning issues: From Scott Obenshain, M.D., UNM SOM Associate Dean, Undergraduate Medical Education.

Elaboration techniques are used to remember new material and commit the information to long-term memory. There are several kinds of elaboration techniques, choose one that suits your needs.

Visual Elaboration: Develop skill in forming visual images by highlighting new material, including concepts, facts and formulas, making sure:

Verbal Elaboration: Connect new material to understanding and long-term memory by focusing more on language elements, using these triggers:

q Concept maps--use to relate concepts, especially relationships between concepts

1. Read the text. Prepare for class discussions. Try to make the text material relevant to you.

2. Preparation. Find out what the discussion will cover in advance so you know what to look for in the readings.

3. Clarity of Purpose. Try to stay focused on an identifiable problem or issue. When reading course material, identify components of an argument while you have the original material in front of you; look for differing opinions. Try to identify the values, beliefs, feelings associated with students'different perspectives.

4. Common Focus. Bring books, handouts, outlines to class with you. If the instructor prepares quotes, overheads, outlines, use this information to focus your ideas in class. Materials the instructor brings to class are a clue to what he/she believes is important.

5. Refer to your text. Use the textbooks and handouts as resources; refer to them often to clarify your thoughts and backup your arguments.

6. Summaries. Watch for instructor summaries of discussions to validate what you think was said and organize your thoughts for further discussion.

Lab Work

Tips for successful completion of lab assignments:

(Prichard, 1994, pp.157-163)

1. Use the scientific process skills of hypothesis formation, identification, and manipulation of experimental variables, and the process of inferring from data.

2. You can learn to improve operational thought through “inquiry-based, hands on approaches” to laboratory investigation. Begin with concrete examples and move toward the general abstract understanding of basic principles.

3. Rephrase the assignment. Learn to rephrase the assignment in your own words to truly understand what is needed.

4. Look for meaningful patterns. Learn to summarize data, look for patterns, infer from the data collected whether the hypothesis can be accepted or rejected; and to identify extrapolation questions, such as generalizations, and implications. What do the results really mean?

Experiential Learning

Experiential learning takes its thrust from the constructivist model which describes the learning process as one of constructing one’s own knowledge. Through the process of active involvement in the learning process, you gain greater depth and usefulness of learning. In other words, the knowledge is created by the learner. In contrast, the didactic method can be characterized as the instructor imparting knowledge to the learner. According to Prichard (1994, p.114), experiential learning:

1. Allows you to discover for yourself, gaining a sense of ownership and increasing the likelihood that you will actually use what you learn outside of class.

2. Creates awareness of the process of learning, which leads to the probability of lifelong learning abilities.

3. Allows you to appreciate the contributions of all learning styles, as well as the learning dimensions of behavior, intellect, and feeling.

2. It may be easier to learn difficult new material with others in a group situation.

4. The discovery method of learning depends on an integration of knowledge. The variety of backgrounds and learning styles inherent to group study can support this process.

Problem-based learning (PBL), as practiced in the medical school curriculum, grew out of a cognitive psychology framework with its emphasis on constructivist, student centered learning. In cognitive psychology and PBL, instructional strategies integrate concepts such as linkage to prior knowledge, contextual learning, discussion and dialogue as learning tools, constructing learning, use of instructional scaffolding, and the primacy of metacognitive knowledge as a fundamental tool for lifelong self-regulated learning.

Training in medicine has reached such a high level of complexity that an effective integrative strategy is necessary to ensure adequate coverage and deep learning in both basic science and clinical skill development. Student-centered, problem-based learning is a teaching and learning strategy which has wide application due to its effectiveness in helping integrate complex primary data, learning of problem solving techniques for clinical practice, integrating medical science across disciplines in a systems understanding of medical functioning, as well as life-long independent learning skills.

In tutorials, you will use a simulated or actual clinical case scenario, described in the context of medical practice, as a starting point for self-directed learning with small discussion groups. Using adult learning theory as the framework, you are encouraged to follow these steps in a PBL session: (Source: UNM Division of Education Development, 1997)

1. Given a written description of a clinical condition, identify the problem(s).

2. Propose hypotheses to explain the condition identified. In this step, you recall prior knowledge, brainstorm or brainstream possible hypotheses to explain the clinical condition, question each other to clarify statements. Explain the mechanisms underlying the proposed hypotheses.

3. Explore what you already know, use it to make lists of questions that can't be answered at this time for which self-directed study will be helpful.

4. Identify needed information such as clinical history, physical, lab and x-ray data.

5. During discussions you will identify learning issues. These are areas of basic science, clinical knowledge and medical procedures beyond your (the group’s) present understanding that will then be researched, learned, and discussed in the group. All members of the group identify, prioritize, and share the key learning issues for research, study and understanding. These learning issues may or may not be addressed in the next tutorial session.

6. New information brought forward through studying the learning issues is systematically applied to the clinical problem and discussed, through several cycles to arrive at an eventual conclusion to the particular case. New learning issues emerge as information is discussed in the group.

The faculty tutors guide you through this process, allowing group members to identify learning issues. The tutor role includes maintenance of group cohesion and functioning, ensuring full group participation, focusing the discussion on important aspects of the clinical problem, answering technical questions to move the discussion along, and importantly, offering the scaffolding to move learning toward integration of important aspects of basic and clinical science that will explain the medical processes you study and answer the clinical questions emerging from the tutorial case study.

For more information, refer to the print materials available in the Office of Cultural and Ethnic Programs (OCEP) student library, BMSB 106, and the office of Teacher and Education Development, BMSB B65.

Concept Mapping:

Concept mapping is a learning, organizing and review tool that emphasizes the relationship between concepts. This is important because medical knowledge and training draws from multiple sources, the different basic science disciplines, clinical practice, and communication. To fully appreciate this complexity inherent in medical training, clinical case studies are used to demonstrate the relationships between basic and clinical science. Concept maps can be used from the beginning of medical school to illustrate concepts and the relationships between concepts. This is an excellent way to purposefully "chunk" information and related concepts for more thorough understanding and for better long term memory and recall.

Concept mapping and diagramming may be something you have already used; continuing this technique purposefully and consistently can also be helpful in medical school. Maps can be constructed any way you like, using concepts and factual information important to you, with relationships between concepts drawn by you reflecting what is important to your thinking and learning style.

Making the maps or diagrams yourself necessitates a thought process that allows for in-depth learning, new information is more likely to move into your long-term memory, and will still be easier to retrieve in a more complete way later on.

Your map can be drawn with as much detail as suits your needs, from broad maps that outline major concepts to very detailed maps showing cause and effect relationships. Newer, more complex subject areas may warrant several maps with varying degrees of specificity, where other, more familiar subjects can be adequately illustrated with less detail.

For a more detailed explanation see Pelley, J.W. (1997) "Success Types for Medical Students." Copies are available in the OCEP lending library, BMSB 106. Also see "Introduction to your Psychological Type," by John W. Pelley, Ph.D., http://www.ttuhsc.edu/success/LSTIntro.htm.

Learn to use "semantic qualifiers": This involves learning to use precise quantifiable language in the clinical setting to communicate patient information. For example, instead of "pain in the right knee" you would use "mono-articular" pain and instead of "pain in joints" you would use "poly-articular" pain, and for "both knees" you would use "bilateral."

Semantic qualifiers are "qualitative abstractions of the signs and symptoms of a case in which an opposing abstraction is either explicit or implicit."

The idea is to develop skill in clarifying and quantifying patient symptoms in order to develop better diagnostic skill. Use of specific terminology that distinguishes symptoms helps to clearly represent the clinical situation in your mind, allowing for clear communication of those representations during clinical case presentation. (Bordage, 2002)

Example 1: "pain over the last two months" could be described as gradual onset (vs. sudden onset)

Example 2: "the pain is in my second and fourth fingers on both hands" might be characterized as pain that is symmetrical (vs. asymmetrical) in the MCP and PIP joints, mostly small joints (vs. large). (Bordage, 2002)

Example 3: "Mr. Clark, a 35-yr nurse, previously in good health presented with a first, acute episode of severe (7/10), right-sided low back pain of recent onset (24 hrs) constant and sharp, that occurred on exertion immediately after lifting a patient from bed. The pain radiates below the knee, to the right lateral part of the leg, the medial part of the foot, and to the great toe."*

The underlined descriptors noted above are focused, show transformations, follow the (clinical) reasoning, and use comparing and contrasting.

Semantic qualifiers are distinguished by these characteristics: (see examples below)

* Adapted from G. Bordage, M.D., Ph.D., Professor & Director Graduate Studies, Department of Medical Education, College of Medicine, University of Illinois, Chicago. "Are semantically competent clinicians born or made?" Presentation- Ottawa Conference, July 2002, and

Strategic Learning and Study Strategies

Strategic Learning

Concept Mapping:


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