Dr. Jill Alban, Ed.D., is Director of Academic Support at Touro University California.
Recently, I reported on spaced repetition. Today, I’m reporting on my students’ experiences with metacognition. While I learned about metacognition in my earlier life as a reading teacher, it is equally applicable to medical students who spend more than a little amount of time reading.
I am the director of academic support at Touro University California.
I was hired to make sure that as many students as possible succeed — passing their tests and their national and state board examinations.
I see students in all of the programs, although, I work primarily with the Osteopathic Medicine students. As a Learning Specialist, another aspect of my job is to make sure that students who qualify for academic accommodations receive their accommodations; counsel students that score below the mean on tests, and are thus in jeopardy of being on probation (and of risk of flunking out at some future point); and meet with students that are on probation and help them develop compensatory strategies to succeed.
In addition, part of my job is to assist all students with study strategies, time management, and most of all, encouragement. Our goal is to have 100% graduation rate, and at this time, we are at 98%.
This month’s piece is about two students who typify those I have seen: Junie and Patricia (not their real names, of course). Both made appointments to see me with the hope of improving their grades. Junie failed her first set of block exams and was required by the Student Promotion Committee to see me. Patricia sought me out on her own accord.
When meeting with a student I begin by asking them what they would like out of our session and then ask them to describe their current study strategies.
Junie was in tears when I met with her. She was flummoxed by her failing grades. She told me that she had been glad the exams were after the Jewish holidays as that gave her almost a full week to study. She did not attend lectures but spent 12 hours a day highlighting, summarizing and rereading the slides, her notes and the objectives. Why, she wondered, had she failed?
Junie was in tears when I met with her. She was flummoxed by her failing grades. She spent 12 hours a day highlighting, summarizing and rereading the slides, her notes and the objectives. Why, she wondered, had she failed?
Patricia was very disappointed with an 83% on her block exams. As an undergraduate, majoring in biology, she had been a straight-“A” student. She felt that she was a disappointment not only to herself but to her parents who were making enormous financial sacrifices for her to attend Touro. She was discouraged because she could not imagine putting in more hours.
She explained her study strategy to me. In preparation for her block exams and for her lectures she previewed the material to be covered, and then reviewed the slides and objectives afterwards. She made flashcards using Quizlet and committed to memory as much information as she felt was possible. When not attending classes or sleeping, she was studying.
Both students were frustrated by their performances and both students wanted tips to improve. I had read much of the latest evidence-based research on study strategies, and I shared with them what I had learned. Highlighting, rereading, visualizing and mnemonics yield little efficacy while distributed practice (also known as spaced repetition) and practice testing yield the greatest study strategy results (Dunlosky, Rawson, Marsh, Nathan and Willingham, 2013.)
Quizlet, a free online study tool, was useful for memorizing. Committing information to long term memory, however, required more than reviewing flashcards. It required repetition, practice and drills over an extended period of time. I suggested they use Anki, another free on-line app, that also utilizes flashcards but includes spaced repetition. Osmosis, also online, offers a free one-month trial. It was built by medical school students for medical school. It is designed for exams, boards and patient care. Both Anki and Osmosis incorporate spaced repetition. Flashcards that are answered correctly will not be repeated until the end of the week. A special value of Anki and Osmosis is that missed questions will reappear at the end of the day’s cycle.
In order to fully make use of Anki or Osmosis, the student has to be aware of what she or he does not know. The student must be able to actively engage in the material. If the student breezes through the flashcards saying, “I know this. I know this,” committing material to memory is not taking place.
The student must be able to actively engage in the material. If the student breezes through the flashcards saying, “I know this. I know this,” committing material to memory is not taking place.
More than one hundred years ago, Hermann Ebbinghause, a German psychologist who could be considered the father of spaced repetition, experimented with how learning and forgetting works. A student that crams for an exam has very little retention after a very short period of time. In fact, Ebbinghause found that forgetting happens almost immediately after a student learns something. Within 20 minutes of learning new information, students can only recall about 60% of the information they just learned. By 9 hours, retention is less than 40% and by 10 days retention is less than 20%.
Importantly, Ebbinghause found that memory is more enduring when material is reviewed days or even weeks apart. An extension to his theory now includes studying in one hour increments, with a ten minute break. This is considered the optimal amount of time for retention (MIT Academic Excellence).
Spaced repetition requires metacognitive capabilities. Metacognition is understanding what you will need to know and having an idea of how to use your skills and resources to learn what you don’t know. It requires the capacity to observe one’s own performance and identify errors and comprehension failures. Interventions that address metacognitive skills are associated with high learning gains and are among the influences that have had the greatest impact on achievement outcomes for students (Hattie 2012). Metacognition is integral to studying efficiently. We all have the potential to cultivate this critical skill.
Metacognition is integral to studying efficiently. We all have the potential to cultivate this critical skill.
The continuation of study immediately after the student has achieved error-free performance is known as overlearning (Rohrer and Pashler, 2007.) Over learning, or continuing to study after one has mastered the material, was thought to enhance students’ performances on exams; however, more recent studies have shown that students that overlearn retain, over time, the same amount of information as those students that simply stopped studying after mastery.
Junie and Patricia had both put in long hours of studying. Junie was a crammer and Patricia was an overlearner. Each student created a study schedule. They blocked out time for studying, class attendance, eating, sleeping and exercising. They planned regular breaks to reward themselves when their scheduled goals had been achieved. After their second block exams both students grades had significantly improved.
After four months, as the director of academic support, I have found that the practices of metacognition and spaced repetition have been effective study strategies for a wide range of students.
[This article originally appeared on the Osmosis blog as “Study Strategies for Success II: Add metacognition to your toolkit”]
Dunlosky, J., Rawson, K., Marsh, E., Nathan, M., & Willigham, D. (2013). Improving Students’ Learning With Effective Learning Techniques: Promising Directions from Cognitive and Educational Psychology. Psychological Science in the Public Interest , 14(1), 4-58.
Ebbinghaus, H. (1885). Ueber das Gedaechtnis. Leipzig.
Hatti, J. (2012). Visible Learning for Teachers: Maximizing impact on Learning. Routledge, New York.
Rohrer, D. & Pashler, H. (2007). Increasing Retention Without Increasing Study Time. Association for Psychological Science, 16 (4), 183-186.
MIT Center for Academic Excellence: Tooling and Studying.web.met.edu/uaap/learning/study/ [Accessed 22 October 2015.]