To all the new interns:

You are starting a new phase of your education. One that is largely self directed. We have our core texts, Rosen’s, Tintinalli’s, and Harwood-Nuss, which you will pick one of and begin to work through. We also have the supplemental, but extremely mandatory books like Robert’s and Hedge’s Procedures in Emergency Medicine. This post is a suggestion to add one more book up front and potentially make your time reading more valuable.

The purpose of this post is to save you from wasting hundreds of hours reading and rereading to find that little has stuck at the end of it. The pre-eminent point of this book is that recall trumps repetition. Actively trying to remember is a hundred fold more productive than rereading.

Here’s a quick summary of other points:

• Learning is deeper and more durable when it’s effortful. Learning that’s easy is like writing in sand, here today and gone tomorrow.
• We are poor judges of when we are learning well and when we’re not. When the going is harder and slower and it doesn’t feel productive, we are drawn to strategies that feel more fruitful, unaware that the gains from these strategies are often temporary.
• Rereading text and massed practice of a skill or new knowledge are by far the preferred study strategies of learners of all stripes, but they’re also among the least productive. By massed practice we mean the single-minded, rapid-fire repetition of something you’re trying to burn into memory, the “practice-practice-practice” of conventional wisdom. Cramming for exams is an example . Rereading and massed practice give rise to feelings of fluency that are taken to be signs of mastery, but for true mastery or durability these strategies are largely a waste of time.
• Retrieval practice—recalling facts or concepts or events from memory— is a more effective learning strategy than review by rereading. Periodic practice arrests forgetting, strengthens retrieval routes, and is essential for hanging onto the knowledge you want to gain.
• When you space out practice at a task and get a little rusty between sessions, or you interleave the practice of two or more subjects, retrieval is harder and feels less productive, but the effort produces longer lasting learning and enables more versatile application of it in later settings.
• Trying to solve a problem before being taught the solution leads to better learning, even when errors are made in the attempt.
• People do have multiple forms of intelligence to bring to bear on learning, and you learn better when you “go wide,” drawing on all of your aptitudes and resourcefulness, than when you limit instruction or experience to the style you find most amenable.
• When you’re adept at extracting the underlying principles or “rules” that differentiate types of problems, you’re more successful at picking the right solutions in unfamiliar situations. This skill is better acquired through interleaved and varied practice than massed practice.
• In virtually all areas of learning, you build better mastery when you use testing as a tool to identify and bring up your areas of weakness.
• Elaboration is the process of giving new material meaning by expressing it in your own words and connecting it with what you already know. The more you can explain about the way your new learning relates to your prior knowledge, the stronger your grasp of the new learning will be, and the more connections you create that will help you remember it later.
• Rereading has three strikes against it. It is time consuming. It doesn’t result in durable memory. And it often involves a kind of unwitting self-deception, as growing familiarity with the text comes to feel like mastery of the content.
• It makes sense to reread a text once if there’s been a meaningful lapse of time since the first reading, but doing multiple readings in close succession is a time-consuming study strategy that yields negligible benefits at the expense of much more effective strategies that take less time. Yet surveys of college students confirm what professors have long known: highlighting, underlining, and sustained poring over notes and texts are the most-used study strategies, by far.
• Rising familiarity with a text and fluency in reading it can create an illusion of mastery. As any professor will attest, students work hard to capture the precise wording of phrases they hear in class lectures, laboring under the misapprehension that the essence of the subject lies in the syntax in which it’s described. Mastering the lecture or the text is not the same as mastering the ideas behind them . However, repeated reading provides the illusion of mastery of the underlying ideas. Don’t let yourself be fooled. The fact that you can repeat the phrases in a text or your lecture notes is no indication that you understand the significance of the precepts they describe, their application, or how they relate to what you already know about the subject.

Summary above from: https://rkbookreviews.wordpress.com/2014/06/06/make-it-stick-summary/

I’ve made sure everyone has access to this book. If anyone has any questions, feel free to email me.

8400 flashcards based on the 7th Edition of Rosens Emergency Medicine Concepts and Clinical Practice.

The flash cards are attached. Here is the site I got them from: