Preparing for the USMLE Step 1 is a monumental endeavor for even the highest-performing medical students. Many students carry the misconception that simply by putting in the time, scores will go up – only to find out later this isn’t necessarily the case.
So before you spend thousands of hours studying this year, remember, there is a solid body of literature demonstrating the quantity of time spent studying does not necessarily correlate with a better outcome. The quality of your effort is more important that the quantity of time you put into studying.
The days of spending endless amounts of time underlining in board review books and passively watching video lectures are nearly over. Most students today realize for learning to be deeper and more meaningful, it requires a high level of active engagement – it requires effort.
Although more passive methods of studying might feel easier, they lack in effectiveness. Nearly every medical student in the country this year preparing for the USMLE Step 1 will incorporate practice testing into their board review armamentarium. Deliberate practice retrieval (i.e. testing) is potent way to prepare for any licensure exam. It’s so beneficial it’s even been coined as “The Testing Effect.”
What many students don’t realize, however, is that even though the practice of retrieval through testing is a great way to study, there are specific methods that can be utilized to make learning even more durable.
Here we highlight three tips to get the most out of your USMLE Step 1 Qbanks this year.
1. Mix Up Your Practice
When you are studying this year, it may be tempting to take questions one subject area at a time. For example, if you enjoy Microbiology, you may find yourself gravitating toward the Micro section of your Qbank.
Once you have used up all of the Micro questions, you may be tempted to move on to Immunology, then to Anatomy and so forth – going subject-by-subject one at a time. Researchers refer this kind of practice as “massed,” and involves clustering of questions from one specific subject area before being tested in others.
This differs from an interleaving approach where two or three subjects might be studied at the same time and questions may pop up from different subject areas. In neuroimaging studies, researchers have found retrieval that is varied (as opposed to massed), results in the stimulation of areas of the brain associated with the development of learning higher-order motor skills.
This differed from the patterns seen during massed practice, which were localized to areas of the brain known for learning less challenging motor skills. These sample principles also apply to cognitive skills.
The more you can mix it up the better. For example, consider studying two or three subject areas at a time instead of one. When you test, vary your approach by taking different types of questions (MCQ, short-answer, etc.). To even gain more benefit, mix up your retrieval methods. Spend some time with your Qbank, then switch gears and write some of your own questions. Mixing things up this way may FEEL uncomfortable, however, the research showing the benefits of varied over massed practice is clear.
2. Space Out Your Practice
The benefits of spacing out USMLE Step 1 practice sessions are critical for achieving more durable learning and retention. Every medical student knows what it’s like to sit through hours of basic science lectures only to go home at the end of the day feeling like all of the information covered in the classroom has totally evaporated like a shallow puddle in the sun.
It’s true, we forget a lot of information. Not only can we feel the information leaving our brain, we can plot it out. The forgetting curve shows us that forgetting information occurs in a predictable process. Our goal is to do everything humanly possible to interrupt the forgetting process.
One of the ways we leverage the benefits of spaced repetition in TrueLearn is by sending bulleted learning points to our students via text message approximately three days after a question is missed. So every time you miss a question from your USMLE Step 1 Qbank, you’ll get a text message approximately three days later with the bottom-line learning point for that case.
Our goal is to strengthen the memory trace and promote the consolidation process to embed the new learning into long-term memory. Spaced repetition is the antithesis of cramming. Although cramming might be okay for adding gains to short-term memory, it does not lead to a more durable and deeper long-term process.
3. More Pain = More Gain
Anyone who has gone to the gym, trained for a marathon, or played just about any sport in the US (or elsewhere for that matter), has likely both heard of and experienced this saying first-hand. Well, turns out the same applies to learning.
Meaningful learning requires lots of effort and researchers have shown positive changes in the brain can occur when put in the effort. There is a single fact that our intellectual abilities are not fixed at birth. They are, in fact, to some degree at least, ours to evolve. To achieve true mastery in performance, its going to require self-discipline, persistence and lots of grit.
Although it may feel good to a engage in a habit of taking a practice tests for USMLE Step 1 here and there, looking at your score, and then reviewing the questions you got incorrect, consider taking a different approach. For example, rather than breezing through questions to get closer to your target whether is be 2,000 questions, 5,000 questions, or 10,000 questions, be mindful as you review your exams.
For example, if you guessed correctly on a topic, it doesn’t mean you know that topic. Knowing why you answered certain questions correctly can be just as important as knowing why you answered others incorrectly.
Try deconstructing questions by changing the stem of each question to make each answer choice correct. When you read explanations to questions, see if you can add to them to make the explanations even more enhanced yourself to leverage the benefits of elaboration. At the end of the day, keep in mind, the more you can be active and engaging with the testing process, the more improvement you will experience.
No matter what, our goal is that when you show up at the Prometric Center to take USMLE Step 1 this year, you’ll feel like you are at home taking TrueLearn questions on your couch!