Critical thinking in nursing

Spaced Repetition is the Study Method Every Medical Student Needs to Know

It’s been said that learning in medical school is like trying to drink from a firehose while simultaneously understanding and remembering it for later use in clinicals, residency and beyond. And while cramming and pulling all-nighters may have gotten you through undergrad, it won’t work in medical school. Sounds impossible? Not with spaced repetition in your corner! Spaced repetition is a proven study method to improve recall and long term retention.  Read on to learn how using spaced repetition is the best way to learn and remember all those important need-to-know facts for medical school, boards and beyond. 

What is Spaced Repetition

You would never expect to go to the gym and gain a massive amount of muscle mass in one training session. Pulling an all-night cram session is equivalent to lifting weights for 8 solid hours. Not only will this not work to achieve your goal of increased body mass, you are likely to injure something! Results happen over repeated sessions. Such as studying and memorization. While our brains are technically not muscles, we should train them like we would if they were. Spaced repetition is a learning technique that allows one to retain information, long-term by reviewing it gradually and at increasing intervals. By reviewing information just before it is forgotten, you are more likely to remember it long-term. 

While using space repetition, active learning and interleaved study methods are effective ways to learn and retain information, they differ in their execution. Here’s an explanation of each. 

This method of study involves learning and recalling new material at specific time intervals or gaps. The time between intervals is increased with the purpose to strengthen retention over time. This way the content is reviewed before it has the chance to be forgotten with the intention to move it from short term to long term memory. 

Example: Watch our Picmonic on Epinephrine  then take the post-quiz.  It will then be built into the Spaced Repetition daily quiz feature when you next log in to review. 

Spaced Repetition vs. Active Learning

With this technique, the learner is focused on engaging with the material by asking questions, discussing the topics with other classmates and even teaching the content to others by applying the concepts and solving problems. 

Example: Students learn a concept in lecture, then divide into breakout groups and take a deeper dive into the concept by teaching to one another and having group discussions while problem solving to understand the material better. 

Spaced Repetition vs. Interleaved Study

With this method of study, different topics and/or skills are approached within a single study session rather than all at once in an isolation or blocked practice session. The study session is conducted by alternating between topics with the intent to build connections between the ideas. 

Example: A med student studies content between pharmacology, pathophysiology and microbiology all in a single session rather than just studying pathophysiology. 

Key Differences Between All 3

bacteria looking in microscope

So in a nutshell, think of spaced repetition as focusing on continual recall and review in increasing intervals with the focus on when you review the material.  Active learning is focusing on engaging with the material while using critical thinking to apply the knowledge learned.  Interleaved learning is mixing different  topics within one study period and making connections between them all with the intent to problem solve. 

Why Does Spaced Repetition Work

Spaced repetition is an evidenced-based practice that allows for better retention in a decreased amount of time. Hermann Ebbinghaus’s research produced what is known as the forgetting curve. He postulated that memories fade over time and the biggest drop in retention happens soon after we learn something. Therefore, it’s  important  to review and recall content soon after learning in spaced intervals to allow for long term retention. Learning just before you are about to forget it without needing to learn it all over again from the beginning. 

The intervals or gaps between your review sessions can increase as time goes on. So if you attend a lecture on microbiology, make a point to review the content the next day. Then in two days review it again and repeat this session in another week and then about a month later. When you make a conscious effort to recall and review this content at strategic points you are literally encoding your brain to retain these memories. This also has the added benefit of highlighting any gaps in knowledge that you may need to strengthen and review.

Also, when you space out the study sessions you are avoiding the dreadful and ineffective “cram sess” And while these sessions might initially help you do well on a test, they often do not allow for long term retention of the material. So to put it simply, spaced repetition works because your brain is constantly refreshing the material. 

How to Study Using Spaced Repetition

Picmonic simplifies this process with its spaced repetition learning algorithms. These formulas automatically tailor your daily study queue to optimize retention as you prepare for exams. By taking a daily quiz with Picmonic, you’re re-exposed to information at strategic intervals, aiding your brain in forming lasting memories. The other great thing about Picmonic is they are very generous with their information and will often link to competing resources such as Osmosis or Lecturio for a more robust experience.

woman sitting at classroom desk character

Most medical students are aware of the The United States Medical Licensing Examination or USMLE. This exam is a requirement to practice medicine in the US and assesses one’s abilities to apply important concepts and knowledge in order to demonstrate fundamental skills to perform patient-centered skills paramount to safe and effective patient care. Some medical students have even referred to the USMLE as “the worst and hardest part of medical school”. And while there are numerous resources such as pathoma, Boards and Beyond and Uworld to supplement your learning, Picmonic has cornered the market on fun and memorable and has built a pathway that coincides with the First Aid for the USMLE step 1 student-to-student guide.   Many students find it advantageous to use Picmonic alongside the First Aid Step 1 book. This can be done in four easy steps Here’s how it works.

Step 1: Develop memory anchors with Picmonics

Start with the content you know you will be tested on. First Aid for the USMLE step 1 is broken down into sections which make it easy to follow along with in the book. As you are going through the book, be sure to supplement your learning with the content you are covering in the First Aid to USMLE Step 1 library.

Step 2: Reinforce your learning with the Quiz features to Reaffirm those memory anchors

Since the First Aid to USMLE can be overwhelming, divide the content  in manageable chunks. For example, as you go through the First Aid for USMLE 2024 content, break the material down by its sections and high-yield principles. These will be the items and content that you will be reviewing in spaced intervals. 

Next, use the quiz feature built right into Picmonic to reinforce your learning. Once you have watched the videos and taken the post-quiz, these topics are automatically set up for you to review whenever you log into the quiz queue. 

Step 3 : Actively Recall and Review the Content to Make long-term memories

Now it’s time to test your knowledge, track your progress, and reinforce your understanding! Go to the daily quiz queue and set up how many questions you would like to be quizzed on daily. I recommend at least 100 questions per day to really reinforce the learning. The nice thing about this feature in Picmonic is there is no need to organize or establish a spaced repetition schedule as it does it for you automatically. It will also adjust based on your recall performance. So for example, let’s say you are learning about Chromosome Components  and you get a fact wrong in the quiz. This will then be prioritized first in your quiz queue as you will now need to review it to ensure you get it right. If you got the facts right, then it will still show up in your quiz queue, but will be spaced out over increasing time intervals to optimize your retention. Other factors are assessed by the algorithms, such as how long it takes you to answer a question and if you use the show the character feature as a hint to answer the question. Either way, they are built right in and proven to work. All you need to do is log in daily to do your quizzes and you are good to go!

Step 4: Use a Question Bank to Quiz

Another nice supplement to your learning is the TrueLearn SmartBanks. Picmonic is part of the TrueLearn family, and is incorporated into the  USMLE Step 1 Question Bank powered by TrueLearn. When you quiz with TrueLearn SmartBanks, you are provided with explanations that are detailed while highlighting Picmonics that are important for you to review and master. This saves time as it allows you to pinpoint areas to improve on while giving you immediate feedback on your performance. And because the TrueLearn SmartBanks mimic the board exams, they allow you to become familiar while you learn.

Sample Schedule Using the Spaced Repetition Study Method for Step 1

For medical students, the sheer volume of material that you are expected to learn and remember can be overwhelming. But it can be done with diligence and structure to your study schedule using spaced repetition.  

student using picmonic to study for step 1

The following is an example schedule for medical students studying for the USMLE Step 1 exam using TrueLearn exam banks and Picmonic for Medicine. This is just an example schedule and can be adjusted to fit individual needs and learning styles. It’s important to stay flexible and make adjustments as needed for patient rounds, clinical duties and rotations. Be sure to take a day off each week to rest, recover and avoid study fatigue! 

Week 1-4: Foundations of Medicine

  • Monday:

    • Morning: TrueLearn Foundations of Medicine (2 hours)
    • Afternoon: Picmonic review (Pharmacology, Pathology) (2 hours)

  • Tuesday:

    • Morning: TrueLearn Biostatistics and Epidemiology (2 hours)
    • Afternoon: Picmonic review (Anatomy, Biochemistry) (2 hours)

  • Wednesday:

    • Morning: TrueLearn Physiology (2 hours)
    • Afternoon: Picmonic review (Microbiology, Immunology) (2 hours)

  • Thursday:

    • Morning: TrueLearn Biochemistry (2 hours)
    • Afternoon: Picmonic review (Pharmacology, Pathology) (2 hours)

  • Friday:

    • Morning: TrueLearn review and practice (2 hours)
    • Afternoon: Picmonic review and practice (2 hours)

  • Saturday:

    • Practice exam or assessment (4 hours)
    • Review and analyze performance (1 hour)

  • Sunday:

    • Rest and relaxation

Week 5-8: Organ Systems

  • Monday:

    • Morning: TrueLearn Cardiovascular (2 hours)
    • Afternoon: Picmonic review (Cardiovascular, Respiratory) (2 hours)

  • Tuesday:

    • Morning: TrueLearn Respiratory (2 hours)
    • Afternoon: Picmonic review (Gastrointestinal, Renal) (2 hours)

  • Wednesday:

    • Morning: TrueLearn Gastrointestinal (2 hours)
    • Afternoon: Picmonic review (Musculoskeletal, Dermatology) (2 hours)

  • Thursday:

    • Morning: TrueLearn Renal (2 hours)
    • Afternoon: Picmonic review (Neurology, Psychiatry) (2 hours)

  • Friday:

    • Morning: TrueLearn review and practice (2 hours)
    • Afternoon: Picmonic review and practice (2 hours)

  • Saturday:

    • Practice exam or assessment (4 hours)
    • Review and analyze performance (1 hour)

  • Sunday:

    • Rest and relaxation

Week 9-12: Practice and Review

  • Monday to Friday:

    • Morning: TrueLearn practice questions (2 hours)
    • Afternoon: Picmonic review and practice (2 hours)

  • Saturday:

    • Practice exam or assessment (4 hours)
    • Review and analyze performance (1 hour)

  • Sunday:

    • Rest and relaxation

Additional Tips

  • Take a 15 minute break every hour to maintain focus
  • Use active learning techniques such as mind mapping or infographics
  • Review and practice consistently
  • Get enough sleep and maintain a healthy lifestyle
  • Keep the process consistent and stick to it!

If you are ready to put some of these study tips and tricks into practice and save time studying and boost your test scores, then check out Picmonic plans for medical students. Here you will save time when studying, boost your test scores, and get your life back. Picmonic for Medicine has 2,000+ need-to-know mnemonics for medical students in 2-5 minute videos as well as study tools and Step 1, 2, & 3 resources to help you learn faster and remember more.

Good luck with your studies!

About the Author

Pamela Schutz, RPN, Medical-Nursing Scholar

Pamela is a registered psychiatric nurse with over 23 years of experience specializing in trauma informed care, substance use and harm reduction strategies. Pamela effectively conveys messages with a passion  for simplifying complex ideas with a rare mix of clinical, educational and business proficiency. She enjoys helping educators to provide an exceptional educational experience for students while making the captivating world of medicine less mysterious.

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