Effective Learning Strategies for Exam Success

  • Post author:Muhammad Yousuf Hayat, Abhinav Tiwari, Rakan Hatem
  • DOIDOI:10.48089/jfo7688147
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Muhammad Yousuf Hayat1 (MBBS, MSc), Abhinav Tiwari2 (MBChB, BMedSci (Hons)), Rakan Hatem3 (M.D.)

  1. Foundation Year 2 Doctor, University Hospital Southampton, United Kingdom
  2. Foundation Year 3 Doctor, University Hospital Southampton, United Kingdom
  3. Trust Grade SHO Doctor, University Hospital Southampton, United Kingdom


The nature of the medical field is such that large volumes of information need to be committed to memory and contextualised and recalled in many different settings such as simulated OSCEs, in a Viva and in clinical scenarios too.

Whether it is in medical school examinations, or whether you are preparing for the FRCOphth exams, utilising effective studying techniques can benefit everyone in terms of encoding key concepts to long term memory and allowing for greater retention over time.

Medicine is a career of lifelong learning. Whether you are an undergraduate or postgraduate medical student, or even a doctor in training we invite you to think about what learning strategies you have employed throughout your academic life to help you succeed with written examinations.

The reality is that there are a variety of learning styles that individuals may use, and these methods have varying degrees of utility. This has previously been highlighted in the literature and refined over time through various models as noted by Honey and Mumford (1). Whether you have traits of an activist, reflector, theorist, or pragmatist, there are commonalities in the way we all learn as underpinned by Kolb’s learning cycle (2).

The academic rigour and nature of medical school and clinical training is such that a significant volume and depth of information needs to be understood and, recalled in both examination settings as well as the clinical environment.

We invite the reader to reflect on whether they have been formally taught how to study or use effective studying techniques – whether it be in school, college, university or beyond.

How do people usually learn?

As the reader, there are a variety of things that may come to mind when we propose the question: “How do people usually learn?”.

As far back as school examinations, you may recall fellow pupils reading notes multiple times, highlighting their textbooks, underlining key information, writing down examinable points, creating mnemonics, and summarising key information to help themselves prepare for assessments.

In fact, these are some of the most commonly used techniques amongst students for recalling information though evidence suggests they may not be the most effective.

Utility of various learning techniques

Re-reading notes is amongst the most popular study strategies used by students (3,4). It requires no training and is economical in terms of time (4).

Whilst re-reading has been shown to improve learning through various mechanisms such as the quantitative and qualitative hypothesis, its utility for recalling information when compared to other studying techniques is inferior (4) and the benefit of re-reading on comprehension of material in the literature is less evident (4). As a result, Dunlosky et al. (4) rated the efficacy of re-reading as having poor utility when compared to other studying techniques (4).

Highlighting and Underlining are also amongst the commonly used techniques used by students to bring attention to potentially important information (3–5). It is believed that information which is isolated by highlighting or underlining may be more memorable than its counterparts (6) otherwise known as the “isolation effect” (6).

Whilst, highlighting and underlining may seem like effective learning strategies in theory, students may be prone to over highlighting, making important details less distinguishable. Many studies assessing exam performance and recall of students who employ this method overlook the appropriateness of the content of student highlighting, with varying evidence of it translating into overall exam benefit (4,6).

Mnemonics have been utilised for decades to create associations and mental imagery that aids the learner to recall information (4). Keyword mnemonics have been demonstrated to translate to successful retention of concepts in a variety of age groups (4,7), and utility of increasingly interactive imagery and pictures may help to increase stability of encoded memory (7).

However, many of these studies have used keywords provided by the experimenters conducting the studies rather than keywords being generated by the students themselves. The efficacy of self-generated mnemonics is less clear, with some studies showing no significant improvement in recall compared with controls (4,7). Students may also have difficulty generating keywords and mnemonics, even with previous training, and the time consuming nature of self-generating mnemonics brings forth a potential issue with implementation into ones studies (4,7).

Summarising is one of the most popular techniques students use to learn. In essence, students distil their understanding of concepts down into a summary of the most high-yield information. Because of its active nature of processing and summarising key information, it has been shown to increase recall as opposed to simply verbatim copying or making notes of relevant pieces of information (8).

The efficacy of summarisation in the literature is unclear, likely due to the fact that summarisation can be assessed in many different ways ranging from writing from as little as a single key word, to sentences and paragraphs or to giving an oral summary to the examiner (4).

Summarising information has been shown to be of greater benefit in essays and free recall as opposed to multiple choice questions (4) and its utility is greater for students who are skilled at distilling pertinent points of information with younger and less experienced students requiring training on this matter (4).

Whilst summarising can be effective for some students, the very act of summarising itself is time consuming and those who are less skilled may require periods of training which compounds this effect too (4).

Active Recall and Spaced Repetition

Active Recall and Spaced Repetition are concepts that are being increasingly used in order to retain large amounts of information and recall it when needed.

In essence, active recall is the process of retrieving information from memory by testing oneself. Spaced repetition is the act of reviewing material at spaced intervals in time. When beginning to learn a concept, the intervals are close together and over time, as the student becomes more familiar with certain concepts, the interval time is increased.

Testing ones memory is often an avoided activity by many students due to the undesirable nature of making mistakes (4).

Despite this, active recall and spaced repetition used in conjunction have been coined as one of the highest yield methods of committing information to long term memory.

One of the conceptual reasons as to why active recall is so effective is due to its effect on being mentally taxing and engaging the mind when learning (9,10). In fact, the literature shows that more unsuccessful attempts at retrieval of information may enhance future learning by increasing the chance of concepts being encoded into long term memory (9,10). Furthermore, incorrect retrieval signals to a student where they can best focus their efforts to enhance their learning and may indirectly reduce test anxiety (11).

The consensus in the literature is that retrieval and recall of information is more than just a means to test students but is also a high utility resource too (4,11).

Dosage and timing of self-testing affects long term memory retention and is closely interlinked with active recall.

Vaughn et al. (12) has demonstrated higher test scores associated with a greater number of times that concepts were retrieved (12). It is clear that memory and recall of concepts decay over time, which was first described by Ebbinghaus in his memory decay model (13). Active recall implemented with spaced repetition aims to intervene in normal memory decay and also reduce the rate of decay over time with more spaced repetitions (13).

This ultimately makes both methods high utility tools to aid in learning, especially given that there is now readily available computer software such as Anki (14) that can aid in implementing these topics into a student’s revision, which can help to save time too.


1.          Expert Program Management. Honey and Mumford Learning Styles [Internet]. 2023. [cited 2023 Jun 7]. p. 1–10. Available from: https://expertprogrammanagement.com/2020/10/honey-and-mumford/

2.          Schultz K, McEwen L, Griffiths J. Applying Kolb’s Learning Cycle to Competency-Based Residency Education. Acad Med [Internet]. 2016 [cited 2023 Jun 7];91(2):284. Available from: https://journals.lww.com/academicmedicine/Fulltext/2016/02000/Applying_Kolb_s_Learning_Cycle_to_Competency_Based.36.aspx

3.          Hartwig MK, Dunlosky J. Study strategies of college students: Are self-testing and scheduling related to achievement? Psychon Bull Rev [Internet]. 2012 Feb 15 [cited 2023 Jun 8];19(1):126–34. Available from: https://link.springer.com/article/10.3758/s13423-011-0181-y

4.          Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving Students’ Learning With Effective Learning Techniques. https://doi.org/101177/1529100612453266 [Internet]. 2013 Jan 8 [cited 2023 Jun 7];14(1):4–58. Available from: https://journals.sagepub.com/doi/10.1177/1529100612453266?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed

5.          Regan A. R. Gurung, Janet Weidert AJ. Focusing on how students study. J Scholarsh Teach Learn [Internet]. 2010;10(1):28–35. Available from: https://scholarworks.iu.edu/journals/index.php/josotl/article/view/1734/1732

6.          Hunt RR. The subtlety of distinctiveness: What von Restorff really did. Psychon Bull Rev [Internet]. 1995 [cited 2023 Aug 3];2(1). Available from: www.uncg.edu/-huntrr/vonrestorff.

7.          Margaret H. Thomas and Alvin Y. Wang. Learning by the Keyword Mnemonic: Looking for Long-Term Benefits. J Exp Psychol [Internet]. 1996;2(4):330–42. Available from: https://www.researchgate.net/profile/Alvin-Wang-2/publication/232580423_Learning_by_the_Keyword_Mnemonic_Looking_for_Long-Term_Benefits/links/5649ed2a08ae44e7a28d74ff/Learning-by-the-Keyword-Mnemonic-Looking-for-Long-Term-Benefits.pdf

8.          Bretzing BH, Kulhavy RW. Notetaking and depth of processing. Contemp Educ Psychol. 1979 Apr 1;4(2):145–53.

9.          Augustin M. How to Learn Effectively in Medical School: Test Yourself, Learn Actively, and Repeat in Intervals. YALE J Biol Med. 2014;87:207–12.

10.        Kornell N, Hays MJ, Bjork RA. Unsuccessful retrieval attempts enhance subsequent learning. J Exp Psychol Learn Mem Cogn [Internet]. 2009 Jul [cited 2023 Aug 4];35(4):989–98. Available from: https://pubmed.ncbi.nlm.nih.gov/19586265/

11.        Karpicke JD, Grimaldi PJ. Retrieval-Based Learning: A Perspective for Enhancing Meaningful Learning.

12.        Vaughn KE, Rawson KA. Diagnosing criterion-level effects on memory: What aspects of memory are enhanced by repeated retrieval? Psychol Sci [Internet]. 2011 Aug 3 [cited 2023 Aug 4];22(9):1127–31. Available from: https://journals.sagepub.com/doi/10.1177/0956797611417724?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed

13.        Noraini Mohd Noor; Kamariah Yunus; Ahmad Mujahideen Haji Yusoff; Noormaizatul Akmar Muhammad Nasir; Nurul Husna Yaacob. Spaced learning: A review on the use of spaced learning in language teaching and learning. J Lang Linguist Stud [Internet]. 2021;17(2):1023–31. Available from: https://search.informit.org/doi/abs/10.3316/informit.216509458456602

14.        Anki – powerful, intelligent flashcards [Internet]. [cited 2023 Aug 4]. Available from: https://apps.ankiweb.net/

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