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Health Sciences Study Tips
Group of students with a teach in a study session

Health Sciences Study Tips

Effective Learning Techniques

The most effective learning techniques are those that foster deep, durable learning by causing the learner to actively engage with to-be-learned material repeatedly over time. These techniques provide the most learning bang for your time buck!

For decades, researchers have been evaluating the effectiveness of various learning techniques, and a 2013 monograph* presented a review of some of those findings, which are summarized below. Ten techniques were rated in terms of learning and retention effectiveness, as well as general applicability across various learning conditions, student characteristics, materials, and outcome measures.

  • The Best – rated as having “high utility” +

    • Techniques you will definitely want to start using now, if you're not already. These boost learning and retention across a multitude of learning conditions, materials, and measures of learning.

      Practice testing (self-testing or retrieval practice)

      • Doesn’t just pertain to actual tests; can be any technique where you attempt to retrieve information from memory.
        • Practice questions – use any provided to you, or write your own.
        • Format notes in a way that fosters self-testing Q&A.
        • Free recall (write or say as much as you can from memory) methods appear to be the most effective, as they do not allow you to rely on cues for answers.
      • Do I really know what I think I know?
        • Self-testing provides important feedback on what you know and do not know, allowing for the efficient focus on what you still need to learn.
        • So, don’t save self-testing for just right before an exam. Self-test daily!
      • Testing improves learning…
        • The testing effect is an extensively researched and very well established phenomenon.
      • …because recalling info strengthens memory traces…
        • The act of retrieving info from memory strengthens the memory trace and thus makes the info more likely to be retrievable in the future.
      • …and potentiates subsequent learning.
        • Probably due to increasing mental organization of knowledge and improved metacognition (knowledge about and regulation of learning).
      • 50% of study time should be spent reflecting on and recalling newly learned info.
        • Spend less time on the input side, and more time on the output side.
      • Practice testing is better with feedback.
        • Check your work, evaluate what you know and don’t know, and make adjustments accordingly.

      Distributed Practice (spaced review/repetition)

      • Spacing study over several sessions rather than in one large chunk (i.e., cramming).
      • Allows you to build upon initial learning by adding greater complexity or detail when re-engaging after a delay.
      • Promotes long-term retention.
        • Better retention than cramming, even when same total study time is used.
      • Some flashcard apps use distributed practice scheduling (e.g., ANKI).
      • Cramming may feel easier.
        • Familiarity with material does come quicker when massed, but familiarity is not mastery.
        • Easier is not better; the more mental effort we have to exert, the better our learning and retention.
      • Desirable difficulties: learning conditions that create challenges and slow the rate of apparent learning often optimize long-term retention and understanding.

      Furthermore, practice testing and distributed practice are even better when you combine them. Spread out your learning, and test yourself repeatedly.

      • How much is enough?
        • For initial learning, students should practice recalling until info is correctly retrieved once (twice is even better).
        • For subsequent distributed reviews, there is no clear “magic number” but more is better (depends on the retention interval).

      These combined techniques are particularly advantageous when retrieval is continued until items are answered correctly more than once within and across practice sessions, and with longer as opposed to shorter intervals between trials or sessions.

  • Pretty Good – “moderate utility” +

    • These techniques show definite promise, but are less broadly effective as the ones already mentioned.

      Interleaved Practice

      • Mixing topics or problem types within one study session.
      • Helps students distinguish among similar concepts.
      • Especially beneficial for problem solving (i.e., math).
      • Slows learning but leads to greater retention (introduces desirable difficulty).

      The next two techniques are similar and overlap some. Both are beneficial because they encourage active processing of content, integrating new information with prior knowledge.

      Self-Explanation

      • Explaining how new info relates to known, or explaining steps taken in problem-solving.
      • Not merely paraphrasing!
      • More effective when done during the initial learning stage.
      • Not enough research has been done on lengthy/complex material.

      Elaborative Interrogation

      • Asking and answering “why?” questions.
      • Generating explanations for why facts/concepts are true.
      • Harder to do when learning new content, as it requires some familiarity with a topic.
  • Not So Hot – “low utility” +

    • Techniques you will want to eliminate, or at least move beyond, because others are so much better. These do not consistently boost learning, whether due to narrow applicability or limited efficiency.

      Highlighting/Underlining

      • Can be okay, if limited to just the key words (most students tend to highlight way too much), and if used as a first step. You will need to do something with those keywords for effective learning.
      • Tends to support fact memory to the detriment of comprehension and application (facts in isolation do not help you gain an overall understanding of a topic or apply knowledge in multiple contexts).

      Rereading

      • Can be okay, if reading and re-reading are spaced over time, but re-reading doesn’t always enhance understanding.
      • A passive learning technique, and less effective than other techniques requiring the same amount of time.

      Summarization

      • Can be effective for those already adept at summarization, which is not the same thing as transcription! Skilled summarizers condense to-be-learned information, put it into their own words, and often reorganize the material into more personally meaningful formats.
      • Definitely better than highlighting/underlining and rereading, but other techniques are better still.

      Keyword Mnemonics

      • Benefits “keyword friendly” materials only, and tests of memory.
      • May not produce durable learning.

      Imagery for Text-Learning

      • Benefits “imagery friendly” materials only, and tests of memory.

      So, now you know which learning techniques are most effective, according to research. However, knowing what to do and actually doing it are two different things. Improving learning effectiveness requires plenty of self-regulation. Regulating your own learning requires you to plan, monitor, evaluate, and adjust your strategies as needed. Self-regulation requires constant reflection on whether or not you are learning effectively. If your academic performance is not satisfactory, do not think you need to “just study harder”. You probably need to study differently. Seek assistance, and be prepared to experiment, as it will take time to figure out when, where, and how to use specific learning techniques.

      *Dunlosky, J., Rawson, K. A., Marsh, E. J., Nathan, M. J., & Willingham, D. T. (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.

      Effective learning techniques are not always easily implemented. If you would like more information and/or personalized advising on this subject, or any other topic related to your learning, please make an appointment with Learning & Disability Resources. We’re here to help!

Strategies for Successful Learning

  • Basic Steps +

    • Preview (before class)

      • Take 10-15 minutes before each class to skim the day’s lecture material
      • Focus on objectives, headings, keywords, diagrams
      • Formulate a mental roadmap of the main points to be covered, and questions you’d like answered

      Listen, Practice and Take Notes (during class)

      • Listen carefully
      • Ask questions, if applicable to class format
      • Document key concepts the professor emphasizes (concepts which are elaborated, repeated, exampled, etc.), topics needing clarification, and answers to your questions

      Read and Create Study Aid (after class within 24-48 hours)

      • Read textbook sections covered in class, if applicable
      • Seek clarification for gaps in understanding
      • Synthesize information from lecture, reading materials, and other resources into a study aid

      • Effective study aids are:

        1. Actively created (drawing is more active than writing; writing is more active than typing; typing is more active than reading); the more active your study aid, the better your recall
        2. Condensed to just the key concepts: you must decide what is important, based on emphasis from professor
        3. Summarized into your own words and organized into personally meaningful formats (outlines, concept maps, diagrams, graphs, etc.); identify relationships within/between material
        4. Visually appealing to you – to the point that you can “see” the information on your study aid when you recall it during test time

      Review (weekly, and before exams)

      • Review your study aids from the entire week (or block, semester, etc.)
      • Refer back to text, lecture notes, and other resources only if you discover concepts on your study aids requiring revision or clarification
      • Write and answer possible test questions; ask “why”, “how”, and “what if” type questions
      • Utilize a study partner/group to identify and practice potential test questions, and explain concepts aloud

      Assess your Learning (periodically, after assessments especially)

      • Am I using study methods that are effective?
      • Do I understand the material enough to explain it to others?
  • Time Management +

    • The greatest academic challenge you will likely encounter will not be the difficulty of the concepts, but the volume of material to be learned. Effective time management is imperative! Managing time effectively starts with figuring your available time, and then prioritizing important tasks within that time.

      Figure Available Time

      • Start with completing a blank week schedule (pdf)
      • Fill in non-flexible obligations (lectures, labs, exams, work).
      • Next, fill in time for sleep (6-8 hours), meals, and exercise.
      • What’s left? Your available time.
      • How will you fill it? That’s the prioritizing part.

      Prioritize Tasks: Urgent vs. Important

      Most students know how to create a “to do” list, which is an important first step. However, to manage your time most efficiently, you must also prioritize those tasks. To guide that, try categorizing each of your “to do” list items using the descriptions below. Urgency is about time-sensitivity, while importance has to do with a task’s value to you.

      1. Urgent and Important: These tasks get our attention, but if most of your time is spent here, it can be stressful. Examples: crisis or pressing problem (overflowing toilet), impending deadline (exam tomorrow).
      2. Important, but Not Urgent: Time spent here is the most gratifying! These tasks tend to become urgent if you procrastinate (keeping up in all your courses).
      3. Urgent, but Not Important: These tasks are time sensitive, but don’t matter that much to you. Delegate or postpone these. Examples: most interruptions (visitors stopping by, phone calls), other digital communications (texts, tweets, FB posts, etc.)
      4. Not Urgent or Important: Spend little to no time on these tasks. Dump! Examples: reading junk email, time-fillers (mindless channel & internet surfing, game apps)

      Schedule your high-priority tasks first. Focus on important tasks, rather than just the urgent. If you run out of time before you fit in all your priorities, revisit your tasks to see if you can do them differently. Look for tasks that can be combined, postponed, or cut altogether. Remember, self-care is important and can vary in urgency.

      Suggestions

      • Getting Started: Plan vs. Actual Schedule (pdf)
        • Plan your week ahead, then fill in what actually happens as the week progresses – be honest!
        • This often exposes over- and under-estimating, to help you create a more realistic schedule.
        • You may need to adjust some priorities (hold on to self-care, look for time-wasters to eliminate).
      • Semester, Weekly, Daily Planning
        • At the start of each semester, note when important school and life events will occur, and plan for them accordingly.
        • Take time each week (Sunday evening?) and daily (before bed or in the morning) to plan your schedule and make adjustments as needed.

      More to Consider

      • Prioritize to-be-learned material
        • You probably won’t have time to learn everything – prioritize the most important information.
      • Manage your study periods
        • When?
      • Are you an early bird or a night owl? As much as possible, pick your most productive time to tackle the most challenging material. Schedule less mentally taxing tasks (chores, exercise) when your brain needs a break.
        • Where?
      • This might require experimentation. Do you need complete silence, all by yourself, or are you better with/near others? Is your focus better at home, on campus, or elsewhere?
        • How long?
      • Optimum concentration is shorter than you think. For every 50 minutes of study, break for 10 minutes. Or, try 25 minutes on, 5 minutes off; repeat for 4 cycles, then take a longer break (Pomodoro Technique). When you’re scheduled to be on task, be ON; save distractions for break time.
      • Other important commitments (family/relationships, community, errands/chores)
        • Plan time to relax and replenish your coping reservoir at least weekly if not daily.
      • Expect the unexpected
        • Leave some flex time in your weekly schedule, if possible
        • Or, re-prioritize tasks and adjust as best you can

      Effectively managing your time can be challenging. If you would like more information and/or personalized advising on this subject, or any other topic related to your learning, please make an appointment with Learning & Disability Resources. We’re here to help!

  • Reducing Procrastination and Perfectionism +

    • Two enemies of effective time management

      Procrastination

      Familiar? Never underestimate the human ability to rationalize! Procrastination, while so very tempting, is devastating to effective time management. The best way to beat it is to recognize when you’re doing it. Try to catch yourself early, so it doesn’t eat up your whole day.

      Why do we procrastinate, and what can we do about it?

      • Task is unpleasant
        • Get it over with. Tackle your least favorite subject first, then follow it up with your favorite.
        • Bribe yourself. Promise yourself a small reward upon completion of a study period.
        • Find a review partner/group. Knowing you’ll be getting together with another to review will provide you with external motivation to prepare. Peer pressure works!
        • Scare yourself. Remind yourself often of the unpleasant consequences of procrastination.
      • Task is overwhelming
        • Break it up. Identify smaller, more manageable, concrete steps involved in completing the overall task.
        • Process vs product. Set a time-on-task (process) goal rather than a task completion (product) goal.
      • Don’t know where to start
        • Start small. Start with something you can knock out relatively quickly, to build momentum.
        • Does it really matter? Just start! Vow to study for just 10 minutes, then 20 minutes, then 30 minutes, etc. Getting started is often the hardest part.

      Procrastination can become a habit, and habits aren’t broken overnight. Keep trying! Self-discipline, usually required to avoid procrastination, can also be developed just like any other habit, through practice.

      Perfectionism

      Do you do it perfectly, or do you get it done?

      Perfectionism can be defined as the setting of unrealistically demanding goals, and the tendency to regard anything short of perfection as unacceptable.

      Perfectionism can be a form of procrastination, such as delaying the start of a task until you’ve found the perfect way to accomplish it, or holding back the completion of a task because it’s not yet perfect. Pursuing a perfect solution will probably end up doing you less good than accepting an effective solution, since attempting perfection wastes valuable time.

      Understanding the difference between perfection and excellence is important. Perfectionists strive for impossible goals, while pursuers of excellence enjoy meeting high standards that are within reach. Improving your ability to know when “enough is enough” will help you let go of perfectionism. Perfectionists tend to focus on product to the exclusion of process. Your educational journey is a process, not just an end destination. Realize that progress is more important than perfection.

      Some students allow perfectionism to get in the way of effective time use, and therefore effective learning. Even though drawing is a great way to learn anatomy, some students resist trying it because they feel they aren’t perfect artists. Other students spend too much time writing and re-writing their notes, trying to get them perfectly neat. These students quickly find themselves falling behind.

      So, forget about “perfect”. You simply don’t have time. Strive for effective! Don’t wait for conditions to be perfect to get started. Do it now, get it done, and keep moving on your journey. Take time at the end of each day to savor your accomplishments.

      Combating procrastination and/or perfectionism can be challenging. If you would like more information and/or counseling on this subject, please make an appointment with Learning & Disability Resources or Counseling Services. We’re here to help!

  • Improving Focus, Boosting Concentration +

    • Merriam-Webster.com defines focus as directed attention, and concentration as the ability to give attention or thought to a single object or activity.

      Your learning is greatly impacted by your ability to direct your attention to a single activity, namely studying. So, how can you achieve better focus and concentration? Effectively dealing with distractions in your study environment, both external and internal, and actively engaging with to-be-learned material are important factors to consider.

      Deal Effectively with Distractions:

      • External
        • Eliminate what you can
          • Environmental – Select a place where there's nothing to do but study.
          • Digital Devices – No TV, silence your phone, turn off notifications, lock down your browser if you need to. Stop attempting to multitask!
          • Auditory – Use ear plugs or noise cancelling headphones. Background instrumental music and/or white noise help some students better concentrate.
          • Visual – Try a study carrel, or face a wall. Pick a spot with as few visual distractions as possible.
          • Physical – Pick a spot where you aren't uncomfortable, but not too comfortable either.
        • Learn to ignore the rest
          • This will take practice, but it can be done!
      • Internal
        • Physical
          • Fatigue – Get adequate sleep! Loss of sleep hurts attention (also executive function, working memory, mood, quantitative skills, logical reasoning, and even motor dexterity).
          • Hunger – Eat healthily at most (if not all) meals, pack nutritious snacks, stay hydrated.
          • Physical discomfort – Get regular exercise, move around during study breaks.
        • Mental
          • "I just can't make myself" or "I just don't wanna"
            • Pomodoro technique – Commit to attempting focused concentration for 25 minutes. Set a timer; begin and do not stop until the timer sounds. Take a 5-minute break. Repeat for a total of four cycles; take a longer break.
        • Distracting thoughts
          • Write them down – Jot down nagging thoughts that pop up while studying, so that you can address them later (on a break), then quickly refocus.
        • Boredom
          • Real life examples – Look up a case study that might help bring this "boring" concept to life for you!
        • Mental fatigue
          • Schedule frequent breaks (10 minutes for every hour of study), during which you change environment and move!
          • Change subjects/topics frequently – We pay better attention to novelty.

      Engage Actively with Material:

      • Don't just read, it's too passive
        • Question the material.
          • use active reading techniques such as SQ3R (Survey, Question, Read, Recite, Review (SQ3R)
      • Don't just highlight, it's not enough
        • Make notes – create a condensed representation of your understanding of the most important material
          • Cornell Notes – key words, associated details, and main points (see Cornell Notes section below)
          • Concept Maps – visual outline showing relationships between concepts (see Concept Mapping section below)
          • Drawings – a picture can be worth a thousand words (especially if YOU draw it!)
          • Flowcharts – great for pathways, processes, cause/effect
          • Tables/Matrices – great for compare/contrast, categorization
      • Use effective (active!) learning techniques
      • Study your most challenging material when you are most mentally alert
      • Find motivation in the desire to learn and understand to the very best of your ability!

      Maintaining concentrated focus can be challenging. If you would like more information and/or personalized advising on this subject, or any other topic related to your learning, please make an appointment with Learning & Disability Resources. We're here to help!

Active Reading Techniques: SQ3R (Survey, Question, Read, Recite, Review)

Do you have problems concentrating on your reading? Do you forget what you read the minute you finish? Following the five steps of SQ3R can help you to process and remember what you read more effectively.

  • Survey +

    • Skim the material to get the main ideas. Resist reading at this point, but try to identify 3 to 6 major ideas from:

      • title, headings, and subheadings
      • introduction and conclusion
      • figures, pictures, charts
      • review questions
  • Question +

    • Question as you survey. Generate questions (in your own words) based on headings, figures, and the major ideas. Reading without questions to answer is passive and a waste of time! Questions you formulate will focus your concentration as you read since it encourages you to search for answers, thus making the reading active.

  • Read +

    • Read to answer your questions. Actively search for the answers to your questions. Since you have already selected the important material (through your questions), you should be able to read selectively and separate out the "fluff" that is not as important. Think about how this new information fits with that you already know.

  • Recite +

    • Recite after you’ve read:

      • Orally answer your questions, or summarize the major concepts.
      • Take notes in your own words; research shows that we remember our own (active) connections better than ones given to us (passive).
      • Connect things you have just read to things you already know.

      The more senses you use, the more likely you are to remember what you read – seeing, saying, hearing, writing!

  • Review +

    • Reviewing, by testing yourself, is meant to be an ongoing process. Test your understanding by asking yourself the questions that you identified. Review your notes, modifying and/or adding to them as necessary to fill in gaps in your knowledge. Your notes can be used to review for a few minutes daily, weekly, monthly, etc.

Cornell Notes

  • Cornell Notes Format +

    • Cornell Notes format:

      Keywords Notes Section
      Summary

      The Cornell note-taking system (developed by Walter Pauk, an education professor at Cornell University) is a method for organizing and condensing notes, and is especially helpful for synthesizing, applying, and evaluating information.

      Some students use this format to take notes during lecture (on the right side), but you may also use this after lecture to organize, summarize, condense, and consolidate your notes from lecture and any other sources you might utilize. For efficient review, your goal should be one source containing the most important information – your condensed notes.

      Making these notes is a time-consuming step up front (strive to create your notes within 24-48 hours after lecture), but it will save you time as you review. Instead of reviewing volumes of material, you'll review just your notes, condensed to the most important points.

      The left side of the paper is for key words and very brief phrases – recall cues. The right side of the paper is for the ideas, facts, and details tied to the items on the left. You can start with either side. It might feel more comfortable for you to start with details and then identify the key concepts from the details. Or, if you have the important concepts identified from lecture, you can start with those and then add the necessary details. Only add as much detail as you need to explain the concept on the left; don't waste your time writing things you already know. Leave space in between ideas so that you can add more info later if you need to (like during weekend review or review with other students).

      In the summary section at the bottom, summarize the objective/topic/concept, etc., in your own words. Or, especially if you’ve been surprised on exams in the past, compose the 2-3 most likely test questions from the material. This will facilitate critical thinking and help you make connections amongst the material. Think about how this new material connects with what you already know, both within this course and across courses.

      When you review your notes, cover up the detail section and attempt to explain out loud the concepts on the left and answer any questions you wrote. And don’t skip the out loud part! As you recite out loud to others or to yourself, you’ll better identify gaps in your understanding…self-testing is very important!

      Keep in mind that new study techniques take time, patience, and diligence to practice and hone, just as all new skills do. Give it some time (3-4 weeks) and then evaluate the effectiveness of your notes based on the outcome of an assessment. Make adjustments to your technique as needed.

Concept Mapping

  • What is Concept Mapping? +

    • Concept mapping is a visual representation of the relationships between concepts. This method can be used to summarize virtually any kind of material you are trying to learn.

  • Constructing a Concept Map +

    • Identifying Phase

      Select the topic to be studied. Since it is going to be subdivided, the size of the topic is not critical. It can be part of a lecture or material that is covered in several lectures. Or you can identify a focus question…something to answer with the concept map. Identify by listing or highlighting facts and concepts that are important to the topic you will be mapping (especially those emphasized during lecture). You might find it useful to write these on small sticky notes, one per note, in very brief form (single word or short phrase).

      Organizing Phase

      Rank the concepts (and facts) from most general to most specific. If you're using sticky notes, create groups and sub-groups of related items, emphasizing hierarchies. Feel free to rearrange items and introduce new items that you omitted initially. Note that some concepts will fall into multiple groupings. This will become important later (cross-linking).

      Layout Phase

      This can be done by drawing (or arranging sticky notes) on a large sheet of paper or a white board, or by utilizing concept mapping software. On a large sheet of paper, arrange the map with the most general concept at the top or center, linked to the less inclusive concepts. The lines linking the concepts can be labeled to explain relationships, if desired. Arrowheads can show direction, cause-and-effect, etc. Try to come up with an arrangement that best represents your understanding of the interrelationships and connections among groupings. Think in terms of connecting the items in a simple sentence that shows the relationship between them. Leave space to grow your map as you review.

      Cross-Linking Phase

      Look for and draw cross-links. Cross-links are links between concepts in different concept groupings, and show how those groupings relation to one another. This is a powerful step in developing integrative thinking.

      Reviewing the Concept Map

      You want the map to make enough sense so that you can verbalize complete thoughts without referring to your text or lecture notes. In reviewing your concept map, consider the following:

      • Accuracy and Thoroughness. Are the concepts and relationships correct? Are important concepts missing? Are any misconceptions apparent?
      • Organization. Was the concept map laid out in a way that higher order relationships are apparent and easy to follow?

      Review examples of concept maps

Test-Taking Strategies

  • Before the Exam +

      • Study! Being well prepared is the most effective way to reduce test anxiety. If you routinely find yourself cramming for exams, begin to study further in advance to avoid procrastination.
      • If you worry about being able to finish an exam in time, do timed practice exams or sets of questions.
      • Put things into perspective.
        • Don't give a test the power to define you. An exam won't tell you whether you're brilliant or stupid and it can't predict your future success.
        • Remind yourself that your entire future doesn't depend on this exam. There will be other exams and other courses. Many students fail an exam or two but go on to graduate from ATSU and have successful careers.
      • Get a good night's sleep. With adequate sleep, your ability to think and to deal with anxiety will both improve. When you are sleep-deprived, your brain does not function as well and you may not be able to recall information as quickly or easily.
      • Try to avoid talking with other students right before the exam because their anxieties may rub off on you. Instead, arrive a little early and take a walk as you give yourself a positive self- talk.
  • During the Exam - Alleviate Anxiety +

      • Eliminate or at least reduce distractions - Consider using ear plugs to reduce distractions. Do your best to tune out what other students are doing and don't worry if they finish early. Often, some of the worst exams are turned in early.
      • Take breaks, if allowed - Excuse yourself to go to the restroom, just to get up and out of the testing room. Take a quick walk and do some deep, belly breathing.
      • Do not try to figure your exam score as you go. Your estimate is not likely to be correct anyway, and it will waste time and mental energy.
      • Do not obsess about running out of time on the test. Check the time periodically (say after you've finished a third of the test), but avoid checking too frequently, as this will only distract you and make you more anxious.
  • During the Exam - Test-Taking Strategies +

      • Preview the test - Begin by reading the directions and jotting down any formulas and memory devices you might forget.
      • To build your confidence, start with the easiest questions. Skip any that you are unsure about but do not flag them (red flags may have a negative connotation associated with them and therefore may increase anxiety).
      • Understand what the question is asking. The single most frequent error students make in a multiple choice examination is to misread, and therefore misinterpret, the question. If possible, circle or underline key words that you need to answer the question. You can also skip straight to the question mark to see what the question is asking. This way you will pay attention to only the information that is required and not any irrelevant information.
      • Paraphrase the question stem by saying to yourself, "I see, I'm looking for...". If the stem provides enough direction, try to anticipate the answer and then look for it.
      • Read all of the choices and keep an open mind. Even when the first or second choice looks correct, don't simply read the other choices with the intent of dismissing them. Consider them carefully. Watch for “all of the above”!
      • Think of multiple choice as a series of true/false statements.
        When an exam gives you choices like “a and b”, “a, b and c”, “a and d” or “all of the above”, take each individual choice and determine whether or not the statement is true or false for that individual choice. Put a “t” by each statement that is true. Then count up all the “t’s” and select the appropriate answer.
        • Sample Exam Question:
          Which of the following joints of the vertebral column are exclusively found in the cervical region?
          A. Zygopophaseal joint
          B. Uncovertebral joint T
          C. Atlantoaxial joint T
          D. A and B
          E. B and C
      • Many students can narrow their answers down to two choices and then have problems selecting the correct answer.
        • Look at each choice and try to determine the word or words that make the choices different. You can also try to put the response choices into your own words and try to answer the question by “matching” your answer with the closest related answer choice.
          • Sample Exam Question:
            The correct path of milk production is:
            A. Lactiferous glands > lactiferous sinus > lactiferous ducts > nipple
            B. Lactiferous glands > lactiferous ducts > lactiferous sinus > nipple
            C. Country > cows > jugs > shelf > “sippy” cup nipple
            D. Lactiferous ducts > lactiferous glands > lactiferous sinus > nipple
        • If two choices overlap or mean essentially the same thing, both are probably incorrect (unless there is a choice of all of the above or both B & C ).
        • Notice partner choices (two choices that are opposites or have a difference of one or two words). Often, the correct answer will be one of these options.
          • Sample Exam Question:
            Which of the following describes diastole?
            1. Relaxation of ventricles
            2. Contraction of ventricles
            3. AV node stimulation
            4. Coronary sinus filling
      • Go back and answer questions that you’ve skipped. Now that you have gone through the entire test and read each question, later questions may help you to answer earlier ones. For example, question #30 may trigger an answer to #2.
  • After the Exam +

      • Review your answers before submitting the exam. This is the time to check for silly mistakes that you may have made. Some students will inadvertently click an answer they did not mean to select, or read through a question so quickly that they didn’t read it thoroughly and may have missed a key detail.
      • However, DO NOT change your answer unless you are 100% positive that the change is warranted. Many students tend to “second guess” or doubt themselves and this leads them to change answers. Research shows that you should change your answer only when you can prove to yourself that your original choice is incorrect. Never change an answer just because of a feeling; that feeling is often simply nervousness.

      Test-taking and test-anxiety can be very challenging. If you would like more information and/or counseling on this subject, or advising related to your learning, please make an appointment with Learning & Disability Resources or Counseling Services. We’re here to help.

  • Multiple Choice Question Strategies +

    • How to Approach Each Exam Item:

      Read the question carefully

      To prompt recall, cover the answer choices and then read the question stem carefully and thoroughly to determine exactly what is the question. For exam items with lengthy question stems (i.e., vignettes or detailed descriptions), find and read the actual question first. Then read the entire stem with the goal of answering that question.

      Think
      Think about all that you know about the topic in question. Try to come up with the answer on your own BEFORE looking at the answer choices.

      Select the best answer
      If you find your answer among the choices, go for it! But read all the answer choices first. Never pick an answer without first reading all of the choices, no matter how sure you are.

      If your answer is not among the answer choices, reread the stem again and think some more. Then, read each answer choice and ask yourself this question: Can I eliminate this option as the correct answer? Look for key words that make an option wrong. On each question, your goal is to narrow it down to no more than two (if you can't narrow it down to just two, skip it and come back later). Now, pick the option that most closely resembles the answer you came up.

      How to Move Through the Exam:

      1st pass – "easy" questions
      Make a quick first pass through the exam, answering all those you can with one reading of the question. Skip the others.

      2nd pass – "harder" questions
      On the second pass, answer the items pertaining to topics you know something about. Reread the stem, break it down into parts, and ask yourself what you know about each piece of info given to trigger recall. Eliminate some distractors and reread the stem. Pick the option that best fits the info provided and actually answers the question. If you still don't know it, skip it again.

      3rd pass – "guessing"
      On the third pass, answer all the remaining items, the ones you couldn't figure out before or know nothing about the topic. See some strategies for guessing below.

      Guessing Strategies:

      When guessing is your only alternative, here are some strategies which may help:

      • Pick the most general answer choice.
      • Pick the longest answer choice.
      • Avoid grammar disagreement – stem and correct answer should agree grammatically (singular vs plural, verb tense agreement, etc.).
      • Avoid absolutes (always, never, must, none, only, etc.); answer choices that permit exception (usually, generally, sometimes, often, etc.) are more often correct.
      • Funny or silly answer choices are usually wrong.
      • Regarding numeric answer choices, pick a middle of the range option.
      • Pick the answer choice that includes key words/phrases almost exactly as in the stem.
      • Be alert for answer choices that are identical in meaning (usually both incorrect), or opposite in meaning (often one is correct).
      • Trust your gut and go with your first instinct. If the stem and one answer choice just naturally flow smoothly together in your mind, follow your hunch.

      Changing Answers:

      Research has shown that changing answers on multiple-choice exams is generally beneficial; students who change answers usually change from wrong to right. Do change your answer if you have an epiphany and can prove to yourself that your first selection is incorrect. Also, go ahead and change your answer if you discover you've misread or misunderstood the question.

      However, don't change an answer:

      • based on low self-confidence and second-guessing (you need evidence on which to base your second selection, not just a feeling),
      • due to over-thinking (take the question at face value),
      • or, if you have truly guessed.

      Other Things to Consider:

      Do not allow yourself to "read into" a question. The question stem sets the task. Take the most literal, obvious meaning of the question. Try to avoid imagining detailed scenarios in which each answer choice could be true.

      Manage your time. Set a timer for the half-way point. When it dings, you should have answered at least half the items. If you haven't, pick up your pace.

      References

      Bauer, D., Kopp, V., & Fischer, M. R. (2007). Answer changing in multiple choice assessment change that answer when in doubt–and spread the word!.BMC medical education, 7(1), 28.

      Sefcik, D. J. (2012). Improve your test-taking skills in a multiple-choice world [Presentation handout]. Retrieved from ACOFP (pdf).

      Test-taking and test-anxiety can be very challenging. If you would like more information and/or counseling on this subject, or advising related to your learning, please make an appointment with Learning & Disability Resources or Counseling Services. We're here to help!

Test Anxiety

Some nervousness is normal before an exam. In fact, moderate levels of anxiety have been found to be beneficial to exam performance. However, at very high levels, anxiety can impair your learning and negatively impact your exam performance. This high, deleterious level of anxiety is what will subsequently be referred to as test anxiety.

A great deal of test anxiety can be reduced with confidence in your exam preparation, so first make sure you are using effective learning techniques. Then try the strategies below, to help bring your test anxiety down to a manageable level. You will most likely need to utilize a combination of techniques, to combat both the cognitive (worry) and physiological components of test anxiety.

Test anxiety can be very challenging. For more information and/or counseling on this subject, or advising related to your learning, please make an appointment with Learning & Disability Resources or Counseling Services. We're here to help!

  • Long-term Strategies +

    • Prioritize self-care to prevent burnout. Get adequate sleep, exercise regularly, and maintain a healthy diet.

      Learn relaxation techniques and practice one or more daily. We tend to perform in the manner we practice, so practicing these while you’re studying can help you utilize them more easily during an exam.

      Study and socialize with people around whom you feel calm, rather than stressed.

  • Day(s) before the exam +

    • Anxiety and feeling overwhelmed often go hand in hand. To reduce your feeling of overwhelm, make a study plan and stick to it. Prioritize your material to be reviewed and then plan to tackle it one chunk at a time. Try setting time limits for your blocks of study and work on the most important material first, so that if you run out of time you'll have utilized your time most efficiently. If you start feeling anxious during study, practice relaxation, counteract worrisome thoughts with positive coping statements (e.g., “I can feel anxious and think at the same time”, “I can get through this”, “If I breathe deeply, I can keep my mind on the task”), and then re-focus on your present task.

      Get at least 30 minutes of exercise on most days, especially if you have an upcoming exam. Exercise is highly effective at reducing anxiety, so it’s worth it to reduce your study time by 30 minutes to get in some physical activity.

      Get adequate sleep, at least 6 hours the night before an exam. Even if you have trouble sleeping, at least lie down and do some deep abdominal breathing. Do not continue studying! You’ll do yourself more harm than good with more study in lieu of adequate rest.

  • Day of, prior to the exam +

    • Avoid review on the morning of the exam, especially within 60 minutes of exam time.

      Eat a light, healthy breakfast.

      Perhaps get a bit of aerobic exercise (e.g., brisk walk) to relieve stress and oxygenate your brain.

      Avoid speaking with classmates if doing so may trigger anxiety.

      Try journaling. Research (Ramirez and Beilock, 2011) has shown that habitually test-anxious students who spend just 10 minutes writing about their worries before an exam score higher than those who write about something else or who write nothing.

      Visualize your success. Imagine yourself calmly and confidently completing the exam. Be specific. Create detailed pictures, actions, and even sounds as part of your success visualization.

  • During the exam +

    • Utilize good general test-taking strategies, and multiple choice question strategies, if pertinent.

      Use shortened versions of the relaxation techniques you’ve been practicing (i.e., abdominal breathing, muscle relaxation, visualization) to respond to physical sensations of anxiety.

      Test anxiety tends to escalate as a student’s focus shifts away from the actual exam questions to a negative internal monologue. Therefore, strive to keep your focus on answering the test questions themselves, and do not let your mind wander into negative “what-if thinking”. Be prepared ahead of time with scripted comments that you can use to prevent or control your negative self-talk, such as: “I reviewed all the material”, “I used effective study techniques”, “I prepared well for this exam”, “I am willing to face each question while experiencing some anxiety”, and “I can remain calm and relaxed”.

      The goal is to remain focused on the exam questions rather than on worry or physiological sensations.

  • Post-exam +

    • Focus on making an objective assessment of your study plan. Determine what went well and what can still be improved. Also, evaluate your anti-anxiety strategies. Practice and maintain those that worked well.

      Remind yourself that this exam was not a measure of your worth as a human being, but only a snapshot of your knowledge on one given day. Getting less than an A+ will not bring the world to an end. While there might be undesirable consequences, you can carry on.

  • Example statements regarding test anxiety and matching interventions +

    • “Just thinking about the exam makes me feel shaky and sick to my stomach.”

      When the exam, and perhaps even studying itself, provokes an uncomfortable or undesirable physiological response, interventions need to adequately address the physical manifestations of anxiety. Such interventions could include abdominal breathing, progressive muscle relaxation, and/or visualization. These techniques must be practiced regularly to be effective. They work because they induce a relaxation response, and relaxation and anxiety are incompatible -- one cancels out the other.

      “I didn’t realize how much I don’t know until I began to review for the exam.”
      or
      “I knew the material cold but my mind went blank during the exam.”

      When self-appraisal leads to worries concerning knowledge deficits, interventions need to counteract the negative self-talk related to the worry. Focus on what you do know, not on the feeling that you don’t know. Start thinking of (or writing) anything that you know about the topic of the question, to get your recall flowing. What we say to ourselves in our minds determines our mood and feelings. It’s not the exam situation that makes you anxious, but rather your thoughts and interpretations thereof. Accept responsibility and make changes to your thinking.

  • References +

    • Johnson, S. (2000). Taking the anxiety out of taking tests: A step-by-step guide. Barnes & Noble Books.

      Ramirez, G., & Beilock, S. L. (2011, January 14). Writing about testing worries boosts exam performance in the classroom. Science, 331, 211-213.

      Sefcik, D., Bice, G., & Prerost, F. (2012). How to study for standardized tests. Jones & Bartlett Publishers.

Stress Management

Stress is generally considered synonymous with distress, and Merriam-Webster.com defines it as “a state of mental tension and worry caused by problems in your life, work, etc.” or “something that causes strong feelings of worry or anxiety”. Yet, not all stress is harmful. Mild to moderate stress can be helpful and good when it motivates and energizes you to accomplish more, and intermittent stress enables you to become stronger for future stresses. However, excessive stress can be detrimental to your physical and mental health. Stress is an inevitable part of life, so it’s crucial for you to develop strategies for keeping stress at a manageable level.

  • Techniques +

    • While stress is universal, solutions are individual. Some of these approaches may make sense for you; others may not be a good fit. Also be aware that some of these strategies might be new skills for you and thus will require practice over time to be effective.

      • Prioritize self-care to prevent burnout (regular exercise, adequate sleep, healthy eating).
      • Recognize and accept your limits.
        • Limit co-curricular activities and eliminate time-wasters in order to make time for more effective relaxation activities like exercise or time with family and friends.
        • Ask for help with and/or delegate tasks where you can.
      • Build relaxation time into your daily schedule.
      • Utilize relaxation techniques such as deep belly breathing, visualizing a calming scene, progressive muscle relaxation, meditation, yoga, and prayer.
      • Talk with friends or family, or write in a journal about what stresses you.
      • Remind yourself to take deep belly breaths periodically in times of stress, such as during exams or practicals.
      • Avoid unhealthy coping mechanisms, such as abusing alcohol and other drugs, over-caffeinating, isolating yourself, or harming yourself or others.

      Sustained or chronic stress can lead to depression in susceptible people. Therefore, it’s important to be aware of your stress level and common signs of depression including: fatigue and decreased energy, insomnia or excessive sleeping, irritability, difficulty concentrating and making decisions, feelings of guilt, worthlessness, and/or hopelessness, loss of interest in friends or previously enjoyable activities, change in appetite, physical complaints that do not ease with treatment, and suicidal thoughts.

      If you feel your stress has become unmanageable, or if you’re experiencing signs of depression, please schedule an appointment with an ATSU counselor. Self-care is an important part of your professional responsibility.

      More info from helpguide.org regarding stress, stress management, and relaxation techniques

Importance of Self-Care

All the demands of graduate and professional education can feel like being caught in a riptide – which can seriously challenge well-being. Self-care in the face of extreme time and mental energy demands is sometimes counterintuitive but crucial. Taking care of yourself is one of the most important factors that will contribute to your success.

Maintaining balance through self-care helps you manage stress, prevent burnout, learn more effectively, and stay healthy. Your non-school time is indeed limited, so spend it wisely doing things that matter most – self-care activities that replenish your coping reservoir.

  • Preventing Burnout +

    • Regular Exercise

      • One of the first activities that many students sacrifice – don’t!
      • Research suggests that devoting 20-40 minutes a day for sustained physical activity improves learning and grades more than using that same time for additional study.
      • Reduces stress, clears the mind, boosts energy.
      • Improves concentration, comprehension, and learning.
      • Causes the brain to create more nerve cells (neurogenesis), makes those nerves stronger and helps them withstand stress, and improves neurotransmitter function, which helps the brain work better.

      Adequate Sleep

      • Concentration, working memory, mathematical capacity, and logical reasoning are all aspects of cognitive functioning compromised by sleep deprivation.
      • Maintain enough sleep (6-8 hours per night) or your exam scores may suffer. Getting less than 6 hours sleep for 5 consecutive nights will result in cognitive performance equivalent to 48 hours of continuous sleep deprivation.
      • A healthy sleep can boost learning significantly; especially learning that involves a procedure.
      • Sleep appears to be important for consolidating the day’s learning; interruption of sleep disrupts the learning cycle.
      • Research suggests that a 30- to 45-minute nap in mid-afternoon can boost cognitive performance, lasting 6 hours and longer.
      • You’re better served by going to sleep if staying up another hour for study will put you into the sleep deprivation category.

      Proper Nutrition

      • Take the time to eat a well-balanced, healthy diet.
      • Gives your body the best chance of fighting off illness; getting sick will only make your life harder.
      • Gives you more energy and better ability to focus on your studies.

      Stress Management

      • Recognize when you need to rest and recharge. Set aside a few minutes daily to relax.
      • Maintain healthy relationships and cultivate new ones.
      • Identify aspects of stressful situations that are under your control; change the things you can change.
      • Eliminate/limit your use of alcohol and other drugs. Choose healthy ways to manage stress.

      Learn more about burnout prevention and recovery.