Growing Pains: Transitioning to a Step-Based Approach

[Isllama]

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M1 year I played it safe--as it seems many students do--and focused on lecture. I read 2 books on medical school, formed a study plan, embraced the learning pillars of spaced repetition and active recall, and worked my ass off every day to perform at my best in class. The payoff was good: I managed to honor all classes possible for me to honor in my first year (with the exception of my second semester medical interviewing thread course). I was quite happy with my performance, but I also found that by using lecture as my main learning source, I was learning minutiae to the same degree as I was learning broad concepts essential to my understanding. In other words, after an exam block ended I was just as liable to forget an overarching concept like the sequence of protein production and export by a cell as I was to forget how many connexins make up a connexon for a gap junction.

Moreover, the "bottom-up" approach, as it were, was haphazard when it came to establishing a conceptual or teleological understanding in the first place: in addition to being intensely focused, I had to get lucky during a period of flash-card review to connect cards without the bird's eye view already in place.

While I did perform well on the NBME subject examinations in my first year, I felt that my long-term recall was not up to the standard I set out to achieve. Additionally, M2 year rolled around, and I knew that lecture was going to have to take a back-seat. So, it was time to get to work.

M2 year:

I decided that, in the interest of wanting to establish a more concept-based understanding of the material, and keeping Step 1 in mind, I would approach M2 year by using resources that give a less-detailed pass of the material to first learn a subject, and then I would dive into progressively greater detail after having built the metaphorical shelves upon which to hang finer and finer details. My first course for M2 was infection and immunity. The immunity portion in particular was fertile ground for experimentation because my undergrad background scarcely enabled me tell you how T and B cells differed--in fact I don't think I could have. So, applying this "top down" methodology seemed appropriate. When I finally worked out my plan, it looked like this:

1. Read and understand the relevant chapter on "How the Immune System Works" (very broad overview, great for concept. We'll call it a level 1 resource)
   
   
2. Watch the relevant B&B material on the subject (level 2, also highly Step 1 relevant)
   
   
3. Annotate FA with knowledge thus far
   
   
4. Pick cards from the LY anki deck that coincide with what I have learned and go over them to firm up board-relevant details
   
   
5. In the days leading up to the test, move onto details from lecture (level 3, doing this last because I don't really want to recall PhD minutiae long-term, it is more important that I retain level 1 and 2 after the exam)
   
   
6. Move into Q-bank practice (concurrently with 5)
   

Now, that is not exhaustive of what I did (I had a bunch of little idiosyncrasies such taking 10 min after a learning block to make a concept map to pull everything together and assess my understanding) but that is it in a nutshell. Or at least, that's how it should have looked. In reality, I spent the first 2 weeks of my 3 weeks before the first exam figuring that out, vetting resources, polling upperclassmen, scouring this very site (how I discovered the featured level 1 resource), learning about Step 1, making plans for my general pathology course, making plans for the micro portion of the course, learning how better to use anki, vetting and understanding how each pre-made anki deck I wanted to use (e.g. LY) was constructed so as to use them best, trying to map out how it would all look in practice, learning how best to coordinate 3rd party resources with lecture, etc. By the time the leg-work was finished, I had about 1 week to sprint through to my exam, and really I only made it to step 3 of my plan for a topic if I was lucky. This congestion bled into my second exam block and put me in similar situation.

The net effect is that I have approx. a 73% in my infection and immunity course, and that's a bit hard on me. I knew I might have to take a hit to surmount the learning curve, and to a degree I was prepared and stipulated to the risk when I set out on this path. Still, I had no idea that the revamp would be this arduous; the logistics of it have been nightmarish. I did not anticipate my grade falling this much in a worst case scenario.

Now, I could have gone back to my old ways and spited concept in favor of honoring my courses; however, in not doing so I feel like I have learned the immune system better than anything I have EVER learned in the past, despite only getting to step 3 of my plan. I may lack some detail, but it can be added to a strong background (more or less the whole idea behind my approach in the first place, just a bit tardy).

I believe that I will be able to effectively apply what I've learning through all this toil to my upcoming pathology course and, with the leg room out of the way, I imagine I will achieve near to what I was before in lecture exams--if not better. Furthermore, I will have the added benefit of a conceptual understanding and consequent long-term retention that will better enable me to make connections between different organ systems, pathologies, details, etc., all pursuant to creating a strong semantic network that will lead me through Step 1 and into my future.

I am now 8 weeks into my M2 year, just finishing up the infection and immunity course, and I need to do well on my NBME under pain of remediation (I shudder at the thought). Again, not a place I thought I'd be.

I suppose I write this post to ask: has anyone else made this transition, or are you making it now? Has it been just as harsh? Better? Did you perish the thought and stick with the old ways? Any success stories? I hope so--if the emotional struggle that has accompanied the past 8 weeks was for not, I'll be quite upset.

If you read this whole post, you have my gratitude.

 

[kb1900]

I had a pretty similar experience when I stippped prioritizing school lectures. I really do believe I understand the material far better, however I can’t really maintain staying around a 1.5xSD above the mean unless I also get through all the lectures and deliberately take notes/flash cards on the details there. If I don’t, I’ll certainly pass still, but I end up anxious about the drop in scores.


So yeah, now adays I use my school lectures as the very last part of my first introduction to the material. I.e read, then pathoma/board review lecture, premade deck anki, school lecture at 2x, notes/anki on any details I can cram later, then qbanks.


Now the struggle is really just the additional workload, but with enough planning it’s been fine enough where I am content if I have the details from my school lectures in anki/note form, even if I don’t get to study them as thoroughly as I hoped before the exam. Getting to do qbank questions and reinforce concepts/disease presentations/pathophys is far more important to me than mastering school lectures.

 

[getdown]

M1 year I played it safe--as it seems many students do--and focused on lecture. I read 2 books on medical school, formed a study plan, embraced the learning pillars of spaced repetition and active recall, and worked my ass off every day to perform at my best in class. The payoff was good: I managed to honor all classes possible for me to honor in my first year (with the exception of my second semester medical interviewing thread course). I was quite happy with my performance, but I also found that by using lecture as my main learning source, I was learning minutiae to the same degree as I was learning broad concepts essential to my understanding. In other words, after an exam block ended I was just as liable to forget an overarching concept like the sequence of protein production and export by a cell as I was to forget how many connexins make up a connexon for a gap junction.

Moreover, the "bottom-up" approach, as it were, was haphazard when it came to establishing a conceptual or teleological understanding in the first place: in addition to being intensely focused, I had to get lucky during a period of flash-card review to connect cards without the bird's eye view already in place.

While I did perform well on the NBME subject examinations in my first year, I felt that my long-term recall was not up to the standard I set out to achieve. Additionally, M2 year rolled around, and I knew that lecture was going to have to take a back-seat. So, it was time to get to work.

M2 year:

I decided that, in the interest of wanting to establish a more concept-based understanding of the material, and keeping Step 1 in mind, I would approach M2 year by using resources that give a less-detailed pass of the material to first learn a subject, and then I would dive into progressively greater detail after having built the metaphorical shelves upon which to hang finer and finer details. My first course for M2 was infection and immunity. The immunity portion in particular was fertile ground for experimentation because my undergrad background scarcely enabled me tell you how T and B cells differed--in fact I don't think I could have. So, applying this "top down" methodology seemed appropriate. When I finally worked out my plan, it looked like this:

1. Read and understand the relevant chapter on "How the Immune System Works" (very broad overview, great for concept. We'll call it a level 1 resource)
   
   
2. Watch the relevant B&B material on the subject (level 2, also highly Step 1 relevant)
   
   
3. Annotate FA with knowledge thus far
   
   
4. Pick cards from the LY anki deck that coincide with what I have learned and go over them to firm up board-relevant details
   
   
5. In the days leading up to the test, move onto details from lecture (level 3, doing this last because I don't really want to recall PhD minutiae long-term, it is more important that I retain level 1 and 2 after the exam)
   
   
6. Move into Q-bank practice (concurrently with 5)

Now, that is not exhaustive of what I did (I had a bunch of little idiosyncrasies such taking 10 min after a learning block to make a concept map to pull everything together and assess my understanding) but that is it in a nutshell. Or at least, that's how it should have looked. In reality, I spent the first 2 weeks of my 3 weeks before the first exam figuring that out, vetting resources, polling upperclassmen, scouring this very site (how I discovered the featured level 1 resource), learning about Step 1, making plans for my general pathology course, making plans for the micro portion of the course, learning how better to use anki, vetting and understanding how each pre-made anki deck I wanted to use (e.g. LY) was constructed so as to use them best, trying to map out how it would all look in practice, learning how best to coordinate 3rd party resources with lecture, etc. By the time the leg-work was finished, I had about 1 week to sprint through to my exam, and really I only made it to step 3 of my plan for a topic if I was lucky. This congestion bled into my second exam block and put me in similar situation.

The net effect is that I have approx. a 73% in my infection and immunity course, and that's a bit hard on me. I knew I might have to take a hit to surmount the learning curve, and to a degree I was prepared and stipulated to the risk when I set out on this path. Still, I had no idea that the revamp would be this arduous; the logistics of it have been nightmarish. I did not anticipate my grade falling this much in a worst case scenario.

Now, I could have gone back to my old ways and spited concept in favor of honoring my courses; however, in not doing so I feel like I have learned the immune system better than anything I have EVER learned in the past, despite only getting to step 3 of my plan. I may lack some detail, but it can be added to a strong background (more or less the whole idea behind my approach in the first place, just a bit tardy).

I believe that I will be able to effectively apply what I've learning through all this toil to my upcoming pathology course and, with the leg room out of the way, I imagine I will achieve near to what I was before in lecture exams--if not better. Furthermore, I will have the added benefit of a conceptual understanding and consequent long-term retention that will better enable me to make connections between different organ systems, pathologies, details, etc., all pursuant to creating a strong semantic network that will lead me through Step 1 and into my future.

I am now 8 weeks into my M2 year, just finishing up the infection and immunity course, and I need to do well on my NBME under pain of remediation (I shudder at the thought). Again, not a place I thought I'd be.

I suppose I write this post to ask: has anyone else made this transition, or are you making it now? Has it been just as harsh? Better? Did you perish the thought and stick with the old ways? Any success stories? I hope so--if the emotional struggle that has accompanied the past 8 weeks was for not, I'll be quite upset.

If you read this whole post, you have my gratitude.

Your #1 problem is that you're not using your time appropriately. You're wasting too much time "prepping". You have too much resources you're "vetting" and trying to form a foundation. The funny thing is you're approaching this as a black and white thing. You either focus on too much detail and forget the concepts or too much on the bigger picture at the expense of your grade. You can do both. You're 8 weeks in, this is not a sustainable way to study in the long term. You're gonna get burned out.

If you want to do well in medical school grades your primary resource should be your class lectures which should be SUPPLEMENTED with other resources to provide context as well as depth to what's in the lectures. You have FA and that should provide you a rough context to what's testable in STEP1 and what to make sure you remember in the long term. Any additional textbook should only be read to give you a better understanding of SELECT concepts you need clarification for not to be read in its entirety.

Here's the kicker: your first 2 year grades aren't even that big of a factor in residency selection. STEP 1 is. The minutiae you learn during the first 2 years are literally going to be useless in the long term practice of medicine. Physiology, Pharmacology, Pathophysiology are higher yield and you'll encounter daily. Even then you're likely to encounter very select pathology and medicication depending on your specialty of choice. FM/IM will be the most relevant to a majority of med school information.

 

[Isllama]

Thank you for the input.

I know that I have sunk too much time into prepping, which is why I am hopeful for the future because it shouldn't take more than a couple of hours at the beginning of an exam block now that I have a handle on it. Plus I looked into my upcoming course plan during the initial stages of my prep for this 8 weeks.

I definitely thought about prioritizing lecture more than anything and was in your camp with the sentiment of your second comment, but the more I explore student forums, the more stories I see about individuals pushing lecture to the side (and doing great on Step 1) for the very reasons you mention in your post: "...your first 2 year grades aren't even that big of a factor in residency selection. STEP 1 is. The minutiae you learn during the first 2 years are literally going to be useless in the long term practice of medicine." This is indeed the reason why I decided to put lecture lower on the pecking order such that I may build a good board-relevant foundation and add to it with lecture. Thus if I forget the lecture minutiae, it doesn't matter as much as forgetting first aid. Also, as I said, despite being measured as proficient by my exams, I did not see the retention that I wanted (mind you, I am not a crammer, so I would not attribute it to that).

The way I rationalized my direction is as follows: medical school lectures are the culmination of a medical school interpreting board exam learning objectives--among a thousand other things the school has to do--and passing them on to PhD's who then interpret those interpretations and come up with lectures in the time that they have not worrying about their research (no ill will to them, but that's reality). How could they conceivably do better to make high-quality, board relevant material than a 3rd party which spends ALL of it's time making a single interpretation and producing organized, relevant materials; it seems no contest to me.

Edit: I should also mention that my intention was never to spend as long as I did on the prep--I thought it would be a much faster process

 

[libertyyne]

Here is the thing and this is N=1
When I was focusing on class material and just supplementing with outside when needed for extra understanding i was consistently 1.5Xsd above the national median for NBMEs.
After revamping m2 to be more focused on step and deprioritizing class material i have gone to .7-1 SD above on NBMEs.
I am going back to focus on more lecture based material and just augment with outside resources as necessary.

 

[Gurby]

Here is the thing and this is N=1
When I was focusing on class material and just supplementing with outside when needed for extra understanding i was consistently 1.5Xsd above the national median for NBMEs.
After revamping m2 to be more focused on step and deprioritizing class material i have gone to .7-1 SD above on NBMEs.
I am going back to focus on more lecture based material and just augment with outside resources as necessary.

This is a tangent maybe deserving of its own thread but:

I'm just wondering if you've been doing QBanks at all, and if your drop in performance on NBME's had a corresponding drop in QBank performance? I've been studying purely with Zanki since halfway through M1 and have been doing well on Kaplan and Rx. I'm worried my qbank performance may be artificially inflated because Zanki is based on the same material the qbanks are drawn from...

 

[libertyyne]

This is a tangent maybe deserving of its own thread but:

I'm just wondering if you've been doing QBanks at all, and if your drop in performance on NBME's had a corresponding drop in QBank performance? I've been studying purely with Zanki since halfway through M1 and have been doing well on Kaplan and Rx. I'm worried my qbank performance may be artificially inflated because Zanki is based on the same material the qbanks are drawn from...

i have not been doing q banks. I experimented earlier on and I felt that the time was better spent focusing on anki. Considering an anki card in itself is a question.

 

[Isllama]

Here is the thing and this is N=1
When I was focusing on class material and just supplementing with outside when needed for extra understanding i was consistently 1.5Xsd above the national median for NBMEs.
After revamping m2 to be more focused on step and deprioritizing class material i have gone to .7-1 SD above on NBMEs.
I am going back to focus on more lecture based material and just augment with outside resources as necessary.

interesting, and more importantly that portends a bad outcome in my future. I'm curious as to the details of your study; are there any threads where you detail your methods?

 

[Isllama]

This is a tangent maybe deserving of its own thread but:

I'm just wondering if you've been doing QBanks at all, and if your drop in performance on NBME's had a corresponding drop in QBank performance? I've been studying purely with Zanki since halfway through M1 and have been doing well on Kaplan and Rx. I'm worried my qbank performance may be artificially inflated because Zanki is based on the same material the qbanks are drawn from...

I believe Q-banks are important for integrating and connecting your knowledge as to create a stonger understanding. Also great for determing where you need the most work.

While anki cards are technically questions, they are more active recall of discrete factoids IMO. Questions demand much more recall than just a single fact (normally) and require an ability to command the information, as you will need to do on Step 1.

 

[libertyyne]

interesting, and more importantly that portends a bad outcome in my future. I'm curious as to thoe details of your study; are there any threads where youg any detail your methods?

i have not outlined my study methods, because they are quite simple. Take the coursehandout and powerpoints and convert them into image occlusion anki cards quickly, afterwards go through cards.

Caution is warranted on drawing any broad conclusions from my experience so far considering I have friends who seem to be doing swell with just zanki on nbme. Its just that I have doubts about the method personally for me.

I believe Q-banks are important for integrating and connecting your knowledge as to create a stonger understanding. Also great for determing where you need the most work.

While anki cards are technically questions, they are more active recall of discrete factoids IMO. Questions demand much more recall than just a single fact (normally) and require an ability to command the information, as you will need to do on Step 1.

I dont disagree with anything you have said, I just felt questions were premature when I didnt have the factoids down. Reasoning through a question is a not a difficult task , as evidenced by performance on mcat.

 

[Isllama]

i have not outlined my study methods, because they are quite simple. Take the coursehandout and powerpoints and convert them into image occlusion anki cards quickly, afterwards go through cards.

Caution is warranted on drawing any broad conclusions from my experience so far considering I have friends who seem to be doing swell with just zanki on nbme. Its just that I have doubts about the method personally for me.


I dont disagree with anything you have said, I just felt questions were premature when I didnt have the factoids down. Reasoning through a question is a not a difficult task , as evidenced by performance on mcat.

I certainly agree that you need to get the facotids down before doing questions. I thought you were implying that anki is a replacement from questions. Apologies.

 

[getdown]

You need to make the distinction between the factoids you learn in class with that tested on the boards. STEP 1 will not focus too much on lecture minutia. You're going to have to learn how to take that test and how they ask questions.

It seems the Anki stuff helps with learning lecture material but likely not as relevant to board studying.
FA and Uworld will help with STEP1 studying but not for your school exams.
Neither will help you on the wards much except for occasional pimping sessions

You will quickly learn that the way medicine is taught and tested academically is very different than how medicine is actually practiced on a day to day basis. Once you realize this and can compartmentalize your studying to fit each goal the better off you'll be. Unless you have photographic memory, the minutia you learn now you'll likely forget by the end of the next block let alone the end of M2 year. Understand the overarching themes and concepts, cram the details as necessary to pass your school exams, and relearn the material for the boards. You will be trained to know what's important for each field on the wards and further specialized during residency. It's not realistic to think you'll remember and be ready to practice medicine coming out of M2 year.

 

[Jesus1]

Go back to the way you studied in M1..Doing well in your med school courses should be your #1 priority. Performing well enough to honor on your exams shows you're learning the material well. Even if you forget, it will all come flying back when you get to your dedicated period. Alternatively, study like you did in M1 and just use a small flashcard deck like the Soze deck (less than 4k cards) to keep the broad HY details fresh. But your #1 priority should be crushing your class exams. You'll paradoxically thank yourself next year when you get to your dedicated period.

 

[7331poas]

I disagree with most people here. Your primary source should be boards and beyond + pathoma + Anki + first aid .

If you are pass fail, who cares what SD you are in lecture?

 

[Med Ed]

While I did perform well on the NBME subject examinations in my first year, I felt that my long-term recall was not up to the standard I set out to achieve.

If you were doing well on NBME subject examinations then you were playing the game correctly. Newsflash: the NBME makes Step 1.

Your concern about long-term recall is common, but it misses something obvious: no one can remember all this stuff. There is simply way, way, way too much of it. You don't really commit to long-term retention until you choose a specialty and start using a core subset of information on a daily basis.

I suggest you reframe the M1/M2 grind a bit differently. The point isn't for you to remember everything you learn. The point is to make you go through everything at least once, so you can drag a lot of it back near working memory during dedicated time. Otherwise there would be no need for dedicated time.

Come to think of it, back in the day there was no dedicated time. Medical students finished M2 and took Step 1 with pencils a few days later. Of course that was when the Steps were still functionally P/F.

 

[7331poas]

Come to think of it, back in the day there was no dedicated time. Medical students finished M2 and took Step 1 on with pencils a few days later. Of course that was when the Steps were still functionally P/F.

And back when first aid was 1/4th the page length it is today..

 

[humblethinker]

If you were doing well on NBME subject examinations then you were playing the game correctly. Newsflash: the NBME makes Step 1.

Your concern about long-term recall is common, but it misses something obvious: no one can remember all this stuff. There is simply way, way, way too much of it. You don't really commit to long-term retention until you choose a specialty and start using a core subset of information on a daily basis.

I suggest you reframe the M1/M2 grind a bit differently. The point isn't for you to remember everything you learn. The point is to make you go through everything at least once, so you can drag a lot of it back near working memory during dedicated time. Otherwise there would be no need for dedicated time.

Come to think of it, back in the day there was no dedicated time. Medical students finished M2 and took Step 1 with pencils a few days later. Of course that was when the Steps were still functionally P/F.

If the student studies the info in M1/M2 in a way that does not actually apply the information (ie: memorizing slides), recalling it into working memory during dedicated will be much more difficult b/c the info was studied, not learned during M1/M2. True learning only happens when your forced to retrieve the memory trace and apply it in a unique scenario.

 

[libertyyne]

If the student studies the info in M1/M2 in a way that does not actually apply the information (ie: memorizing slides), recalling it into working memory during dedicated will be much more difficult b/c the info was studied, not learned during M1/M2. True learning only happens when your forced to retrieve the memory trace and apply it in a unique scenario.

The studies looking at active retrival using anki and correlation to Step scores would beg to differ with your differentiation. Plus in learning the factoids the larger conceptual picture and interrelations often fall into place.

 

[humblethinker]

The studies looking at active retrival using anki and correlation to Step scores would beg to differ with your differentiation. Plus in learning the factoids the larger conceptual picture and interrelations often fall into place.

What is the definition of active retrieval in the anki study? Can you post the study?

 

[libertyyne]

What is the definition of active retrieval in the anki study? Can you post the study?

Cant direct link through my proxy. It is a small study.
Perspect Med Educ. 2015 Dec; 4(6): 308–313.
Published online 2015 Oct 23. doi: 10.1007/s40037-015-0220-x
PMCID: PMC4673073
PMID: 26498443
Student-directed retrieval practice is a predictor of medical licensing examination performance

 

[humblethinker]

Cant direct link through my proxy. It is a small study.
Perspect Med Educ. 2015 Dec; 4(6): 308–313.
Published online 2015 Oct 23. doi: 10.1007/s40037-015-0220-x
PMCID: PMC4673073
PMID: 26498443
Student-directed retrieval practice is a predictor of medical licensing examination performance

awesome, thank you!

 

[Espressso]

This is a great thread.

 

[Scrubb]

Anyone have a curriculum where you do anat/phys for all systems first year, then path/micro/etc for all systems 2nd year? For this type of curriculum, if you're using Zanki or Lightyear first year along with classes, do you just suspend most/all the path/disease-related cards (since path and most diseases aren't covered first year)?

 

[libertyyne]

Anyone have a curriculum where you do anat/phys for all systems first year, then path/micro/etc for all systems 2nd year? If you're using Zanki or Lightyear first year along with classes, do you just suspend most/all the path cards (since path isn't touched first year)?

Yes.

 

[Isllama]

You need to make the distinction between the factoids you learn in class with that tested on the boards. STEP 1 will not focus too much on lecture minutia. You're going to have to learn how to take that test and how they ask questions.

It seems the Anki stuff helps with learning lecture material but likely not as relevant to board studying.
FA and Uworld will help with STEP1 studying but not for your school exams.
Neither will help you on the wards much except for occasional pimping sessions

You will quickly learn that the way medicine is taught and tested academically is very different than how medicine is actually practiced on a day to day basis. Once you realize this and can compartmentalize your studying to fit each goal the better off you'll be. Unless you have photographic memory, the minutia you learn now you'll likely forget by the end of the next block let alone the end of M2 year. Understand the overarching themes and concepts, cram the details as necessary to pass your school exams, and relearn the material for the boards. You will be trained to know what's important for each field on the wards and further specialized during residency. It's not realistic to think you'll remember and be ready to practice medicine coming out of M2 year.

I like to think that this is the direction that I have tried to take (with the exception of our opinions on Anki for boards).

 

[Isllama]

Anyone have a curriculum where you do anat/phys for all systems first year, then path/micro/etc for all systems 2nd year? For this type of curriculum, if you're using Zanki or Lightyear first year along with classes, do you just suspend most/all the path/disease-related cards (since path and most diseases aren't covered first year)?

I have the same cirriculum; however, as I mentioned, I did not begin to use pre-made anki decks until my M2 year. That said, suspending the cards you definitely do not know is fine, but you need to make sure that you revisit that deck M2 year once you get into the pathology. This is a bit convoluted, and it is part of the reason I made my own cards and stuck to lecture M1 year. 3rd party resources correspond better with your progression during M2. Hopefully, because you have started early, you'll avoid the strife I've described here.

 

[Isllama]

The studies looking at active retrival using anki and correlation to Step scores would beg to differ with your differentiation. Plus in learning the factoids the larger conceptual picture and interrelations often fall into place.

Well, it is certainly different for everyone, but as I mentioned, I was having difficulty conjuring the concept from a bunch of fragments. Almost like trying to put a puzzle together without seeing the picture on the box first, if that's a good analogy.

 

[libertyyne]

Well, it is certainly different for everyone, but as I mentioned, I was having difficulty conjuring the concept from a bunch of fragments. Almost like trying to put a puzzle together without seeing the picture on the box first, if that's a good analogy.

im not disagreeing, its just that the literature I do know of (which is limited) indicates that anki even with reliance on a bunch of fragments works. The study however relied upon people making their own cards, which may be in part responsible for ability to get the larger picture. To build on that analogy tho, there are dozens of puzzle pieces in anki which dont make sense , until you have all the puzzle pieces memorized and then they materialize into this beautiful picture which reveals the concepts to you. atleast my experience has been such.

 

[fldoctorgirl]

im not disagreeing, its just that the literature I do know of (which is limited) indicates that anki even with reliance on a bunch of fragments works. The study however relied upon people making their own cards, which may be in part responsible for ability to get the larger picture. To build on that analogy tho, there are dozens of puzzle pieces in anki which dont make sense , until you have all the puzzle pieces memorized and then they materialize into this beautiful picture which reveals the concepts to you. atleast my experience has been such.

Just an M1 here, but I think your point about making your own cards is key. When I tried to use cards made by someone else in my class, my grades dropped because I couldn’t conceptualize all of the information well in my head. When I make my own cards, it’s my way of getting the “big picture” to connect them all together.

 

[Isllama]

im not disagreeing, its just that the literature I do know of (which is limited) indicates that anki even with reliance on a bunch of fragments works. The study however relied upon people making their own cards, which may be in part responsible for ability to get the larger picture. To build on that analogy tho, there are dozens of puzzle pieces in anki which dont make sense , until you have all the puzzle pieces memorized and then they materialize into this beautiful picture which reveals the concepts to you. atleast my experience has been such.

I think you are correct in that it does work both ways. I was probably doing well in M1 oweing in part to making my own cards. This is a whole other conversation, but it took me ALL of my time. I didn't have really any free time M1 year aside from a daily trip to the on-campus gym. The weekends were all catch-up time. So that it part of the reason I have transitioned to the pre-made cards that are well regarded and backed by people who have perfomed well on step. Being that I do not make the cards I use now, it is all the more important that I keep in mind the need to establish concept in some way or another.