7 Evidence-Based Study Strategies (And How to Use Each)

Hard work alone won’t carry you through medical school. The students who struggle most are usually putting in the hours, just using strategies that don’t work. Rereading notes, highlighting, and reviewing slides the night before are among the least effective ways to encode information for the long term.

We can do better. The same evidence-based thinking that drives clinical medicine applies to how you study. Here are seven techniques with the research to back them up.

1 | Spaced Repetition

Spaced repetition is one of the most well-supported study techniques in medical school. We can thank the psychologist Herman Ebbinghaus for studying his own memory and generating what is known as the Forgetting Curve. In its simplest terms, the Forgetting Curve demonstrates that after forming a memory, we gradually forget more and more of it over time. With repeated attempts to retain the information at increasing intervals, the memory becomes more durable just before we forget it.

We know from the fundamentals of neuroscience that repetition strengthens neural connections and helps us remember information more effectively. The problem is that we have far too much information to learn. We can’t repeat every fact we need to know on a daily basis. 

Enter the Spacing Effect. By repeatedly exposing a piece of information at increasing intervals between repetitions, we can optimize memorization and retain the most information in the least time.

Spaced repetition is most powerful when the timing is just right. If too little time elapses between repetitions, the information isn’t reinforced as strongly. If too much time passes, you forget and are unable to recall the desired information.

How to Implement Spaced Repetition

If we see the same information multiple times over increasing intervals, we’ll be far more effective at encoding those facts into long-term memory. This is why cramming is so ineffective. Studying for 8 hours over 2 weeks will generally yield better performance than studying for 8 hours in a single sitting.

Tools and systems can help streamline and automate processes. Take the same approach with spaced repetition. You could create a study schedule for yourself that outlines when to review both older and recent lectures.

Alternatively, you can offload the process to other apps, like Anki, which will test you on bite-sized pieces of information through flashcards and automatically schedule the cards based on each card’s difficulty of recall.

Common Mistakes with Spaced Repetition

The most common mistakes are procrastination and cramming just days before the exam. This undermines any of the potential advantages of spaced repetition.

When practicing spaced repetition, make sure you’re using effective study strategies and not simply rereading your notes. Rereading your notes is a form of recognition, whereby you look at some facts and tell yourself, “Oh yeah, I know that.” This is unreliable.

Instead, spaced repetition is most effective when combined with active recall, in which you test yourself on the answer. 

2 | Active Recall vs Passive Learning

Active recall is one of the most effective study techniques for medical school, and it works by using the Testing Effect to your advantage. If you’re already using active recall, chances are you love it for the drastic improvement in performance it brings. If you aren’t using it yet, there’s a bit of a learning curve that may be discouraging.

Expect active recall to be difficult, as active learning methods are, by definition, far more challenging than passive ones.

How to Implement Active Recall

When it comes to active recall, create flashcards through Anki or use practice problems, which have the added benefit of practicing higher-order thinking.

There are other ways to incorporate active recall, though. For example, you could write or sketch out everything you know about a certain topic without looking at your notes. Be as thorough as you can be. Afterward, check what you’ve written compared to your class notes for accuracy and to fill in points you may have missed.

Common Mistakes with Active Recall

Many students try active recall for a short period of time, only to give up soon after because they find it difficult. The key is to understand that if it feels difficult, that means it’s working. And with anything in life, with practice, you’ll get better at it. It becomes easier with time.

Another common mistake is studying facts in isolation. Particularly with flashcards, students may focus too much on individual facts without adequate comprehension. Don’t neglect comprehension, which means truly understanding the relation between ideas and how certain concepts are similar or different.

Lastly, remember to not only practice recall but also check your answers. If you’re practicing recall without verifying the accuracy, you may be reinforcing incorrect information.

3 | Desirable Difficulties

Closely intertwined with active recall is the concept of desirable difficulties. This states that a learning task requiring considerable effort will improve long-term performance, even though it may initially slow learning.

Research demonstrates that traditional, easy forms of passive learning yield better short-term performance, whereas more difficult tasks, such as learning with active recall, lead to improved long-term performance.

Think of it like going to the gym. If you bench press 10-pound dumbbells, you’re technically doing chest exercises, but you’re not challenging yourself enough to improve. This is like passive learning. On the other hand, if you bench press 100-pound dumbbells in each hand, you’d be exerting yourself to a far greater capacity, resulting in muscle breakdown and, ultimately, hypertrophy. This is a desirable difficulty that you can more readily achieve with tools such as active recall.

The same principle applies directly to how you study for medical school exams. Reviewing a pharmacology lecture with your notes open feels productive. Closing everything and writing out the drug classes, mechanisms, and side effects from memory is harder and slower, but that friction is exactly what drives retention. The discomfort of not immediately knowing the answer is the signal that learning is actually happening.

Desirable difficulties is an overarching principle that serves as a common thread throughout the 6 other evidence-based learning techniques.

4 | Elaboration

Elaboration refers to further describing and explaining various ideas or concepts that you’re studying to solidify your understanding of the material.

How to Implement Elaboration

The concept of elaboration sounds great, but the tricky part is how to implement it effectively. Here are a few suggestions to help:

1. Generate questions for yourself about how various concepts or principles work and the underlying reasons why. Try answering on your own first, and then turn to your class materials or study buddies for verification and further explanation.
2. Cross-reference different ideas, even if your professor or class materials didn’t explicitly do so. By comparing and contrasting relatable components, you’ll better understand the nuances of each and how they interplay, and you’ll be less likely to confuse the two.
3. Make the content relatable. When elaborating on a concept, relate it to your own life experiences or memories to create a stronger memory anchor. Integrating new material with concepts you already know helps you organize new ideas and facilitates recall later, such as on test day.

Common Mistakes with Elaboration

Don’t be overzealous with your elaboration, meaning keep it within the scope of what’s accurate and reasonable. Overextending elaboration can cause further confusion in the long run.

Practicing elaboration with small groups, such as with the Feynman technique, can be helpful, but beyond three people, the drawbacks begin to outweigh the benefits.

5 | Interleaving

Interleaving is one of the best study techniques for medical students who struggle with burnout during long sessions, and it’s built around alternating between topics rather than blocking off time for a single subject.

The literature suggests that this strategy is particularly helpful with subjects requiring problem-solving, such as physics, chemistry, or math. Why is this counterintuitively beneficial? Interleaving facilitates the identification of links, similarities, and differences among ideas.

How to Implement Interleaving

Interleaving simply means switching between topics, ideas, or subjects during a study session. Avoid studying one focused area for too long.

As you interleave, approach the topics and subjects in different orders to facilitate improved understanding. While doing so, make it a conscious practice to consider how you can link principles across the different concepts.

The added benefit that goes overlooked is sustained endurance. When you’re strategically shifting between topics, you can ward off burnout and boredom through novel stimuli. I used this practice almost religiously as a medical student to get through study marathons on a near-daily basis.

Common Mistakes with Interleaving

Interleaving requires a bit of calibration. If you spend too little or too much time on a single topic, it can prove detrimental. Switch too often, and you begin to face the issues of multitasking, whereby you fail to achieve meaningful deep understanding, and effectiveness drops. If you spend too much time on one area, you’re not interleaving; you’re just performing traditional blocked studying.

A good rule of thumb is to complete at least one or two Pomodoro blocks before switching to a new topic. At the end of the study session, summarize the relevant key points, but do so in a different order than when you first reviewed the information.

6 | Concrete Examples

Concrete examples are a useful tool for facilitating understanding of complex or difficult concepts, and they’re quite simple. Find relevant examples that illustrate the principles from a lesson you’re trying to learn, and ensure you deeply understand how the concrete example is a reflection of this principle in practice.

How to Implement Concrete Examples

To implement this practice, collect examples and then explain how the example illustrates the principle you’re attempting to learn and repeat. You can also create your own examples or exchange examples with your study group for added benefit.

Common Mistakes With Concrete Examples

When practicing this technique, ensure that the examples are actually relevant and accurate to the concept or principle you’re studying. Too often, students find poor examples online, from friends, or from other sources that reinforce an incorrect understanding.

7 | Dual Coding

Dual coding is the practice of presenting information about the same concept in multiple media. For example, you may read about a concept in a textbook and additionally use visuals and diagrams to drive the point home.

How to Implement Dual Coding

To most effectively implement dual coding, don’t simply look at a visual and think, “Ah yes, I know this,” but rather actively explain the concept in your own words. Even better, take the information you’ve read about in a textbook or heard about in lecture and create your own visuals.

This goes back to the summary sheets and synthesis questions in our How to Take Notes guide. This will not only be helpful during the active process of creating the diagram, but you will also have a condensed, high-yield visual for future reference.

Common Mistakes with Dual Coding

The most common mistake to avoid with dual coding is passively reviewing the various forms of media rather than approaching the practice through active methods. To demonstrate mastery, you should be able to draw necessary figures from memory without cheating and looking at your notes.

Put It All Together

These seven techniques work best when used in combination. Spaced repetition without active recall is less effective. Active recall without elaboration leaves gaps in understanding. The students who see the biggest gains layer these techniques deliberately rather than committing to one and ignoring the rest.

Even the strongest study habits can fall apart on exam day if you haven’t also sharpened your test-taking tactics. That’s especially true for high-stakes, time-pressured exams like the MCAT. Our test-taking tactics guide covers exactly what to do when the pressure is on.