Learning How to Fetch


The way we do learning in medicine is all wrong.

As students, we fall prey to predictable, unproductive and ineffective learning strategies, passed down from our predecessors as lore or invented by us through intuition.

But we can fix this by learning how to fetch. How do you fetch? Once you identify a goal, it conists of three steps.


1. Retrive the Ball - "THE BALL, I WANT THE BALL"


2. Receive Feedback - "OH, HE SAID I AS A GOOD BOY"




Fallacies of Learning

3 Main myths:

  1. MYTH #1 - "Cramming" is an effective study strategy

    • Spaced repetition and interleaving is much more effective as opposed to massed practice

    • Nearly 300 studies have shown this to be true - massed practice is ineffective

  2. MYTH #2 -Re-reading is an effective study strategy

    • Perpetuates the illusion of mastery = mastering the text, slides etc is NOT the same as mastering the concepts behind them

      • Since we are familiar with text we ware reading we we think we know it

      • But it does not mean we understand how to apply concepts or connect them with existing knowledge

  3. MYTH #3 - In the interest of time, we should avoid learning modalities that are difficult

    • In educational literature, learning that is more effortful is both longer lasting and more versatile. The harder you work = the longer you'll remember

    • Effortful learning strategies:

      1. Summarizing key concepts of a lecture from memory

      2. Peer teaching a concept you just learning with no reference materials

      3. Struggling through a problem that you have not been taught how to solve

    • Whether you succeed or fail, our expanded effort yields powerful an durable learning

Breaking it down: How to Fetch

  1. Retrieval - the act of information retrieval from your brain, the learner calls information to mind

    • It's about getting information out of your head, not getting information in

    • Works because:

      1. It's near impossible to mix retrieval and massed practice

      2. There is no place for the illusion of mastery - you either know it or you don't

      3. It's difficult - effortful learning is more effective (see above)

      • Embrace difficult, spaced repetition and interleaving

  2. Feedback

    • Give feedback to those you are educating - are they learning things? Are they able to apply the things they learn?

    • Make sure someone is ready for it- consider delaying

      • Ask: "Are you ready to receive feedback?"

    • Can also build feedback into your education

    • Learners - seek out feedback

  3. Reflection

    • Difficult; should take place no matter what in the presence or absence of feedback

    • Jenny Rudolph, PhD -

      • "Reflection requires a series of micro skills; recognizing I have thoughts; being able to bystand them, tolerating what I learn about myself, tolerating fallibility, motivation to consider changing my thinking, accepting and celebrating my ways of thinking."

Self Guided Retrieval

Being a Good Educator - Promoting Retrieval

  • Teach-back: student teaches educator about subject from memory after lecture

  • Simulation

  • Allow for uncomfortable amount of silence

    • We often are too quick to answer question if student does not answer immediately; remember, difficult learning = more effective


So go out there and fetch

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