Episode 39

Episode 39: How To Study Effectively

Nov 17, 2021

CRNA 39 | How To Study Effectively

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You asked for it, and we are delivering today by sharing some of our most effective study tips as you navigate anesthesia school! The sheer volume of information can feel overwhelming, but creating an effective study practice personalized to you will serve not only through test time, but well into your CRNA career!

Today, we are highlighting the reasons why HOW you study is equally as important as WHAT you study when it comes to being successful! Tune in for this episode as we dive into-

  • The critical difference between memorization and true compounded understanding

  • The cumulative power of combining learning styles

  • How assessing and quizzing yourself along the way sets you up for confidence

  • Why self-care is essential for knowledge retention as you move through school

  • How to integrate new information with emotional experiences to create impactful long-term memory connections

  • The importance of acquiring unique perspectives on one single topic

  • Best practices to help you navigate test anxiety and give yourself the highest chances for success

Happy studying, future CRNA! You’ve got this!

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How To Study Effectively

I have a gift to share with you. We have a special going on that you get ten days for free inside CRNA School Prep Academy. This means you can come in for ten days risk-free, book a mock interview, and take advantage of our guided Q&A sessions and all the other courses that we have to offer ten days. I look forward to seeing you there. All you need to do when you check out will say, “Have a coupon?” You click that, and you type in 10FREE. We hope to see you there. I wish you all the best and safe travels if you are traveling. We will see you soon and back at the show.

We are going to cover different things I have learned about studying. Back when we first started this show, I shared with you guys some study tips that I used during school. It continues to be one of the most downloaded episodes that we have, which says to me that you guys clearly want more help in this area. A book that, first and foremost, I am going to recommend that you read, whether it is a physical book or on audio, is Make It Stick.
A lot of programs recommend this book to their students to read prior to starting school. I have been listening to this book and taking notes, and it is awesome. It has been very eye-opening to me because I thought I knew how to study. Back in 2010, when I got rejected from nursing school, I finally came to the conclusion that I did not know how to effectively study for myself.
As a younger student, I found out I had dyslexia. I always felt like I was stupid because of it, to be quite honest, which was unfortunate. This is all on me. I had plenty of good mentors in my life. My parents and everyone around me said, “Jenny, you are not stupid. You are smart. You can do this.” I believed that I could not easily learn the way I saw other students learn.
I immediately thought, “It means I am not capable.” It was not until I was faced with not pursuing nursing that I was forced to say, “I have got to figure this out. I should be able to do this. I want to go to do this. How can I get better grades so I can get into the College of Nursing?” At that time, I started googling study techniques and trying them all, meaning I was open to trying anything, even, “Let’s listen to the notes in my sleep.” I would bring a recorder with me to class and relisten to those recordings while I slept. I tried all the different things. I try to utilize all of my senses and what I found was I can get straight A’s.

Understand Versus Memorize

It was a very eye-opening experience for me to go from being B, C student to a straight-A student. All because I was willing to do something different with my study techniques and to try to learn a different way for me; not doing the typical read and try to memorize. What I started doing instead is I tried to understand versus memorize. It sounds basic and silly but I can tell you, even if you do not realize you are doing it, you are actually memorizing versus understanding. Especially if you are trying to look at a study guide and trying to memorize the study guide, you need to be understanding what you are studying versus trying to memorize what you are studying.
Your memory is a very unique part of your body. Your chemical makeup and your brain are amazing. First of all, it is super cool. There are neural pathways that connect different thoughts and emotions, which are very complex. That being said, learning is no different. Your brain creates pathways, so you can learn how to speak, walk, and eat.  Think about a child, all the things that they have to do and learn to function as a normal person. They have to learn a lot. Does it happen overnight to cram to become from a baby to a toddler or from a toddler to a school child? No.
It takes years for them to learn information that they are expected to know as an adult. First and foremost, this stuff takes time. To develop real true knowledge and a deep understanding takes time. As a human who also loves Amazon, who likes that you can order something one day and have it on your doorstep the next day, it is instant gratification like, “I want it, and I want it now.” You are impatient. You do not want to wait. We get impatient with ourselves when it comes to learning. At least, I know I did where I wanted to see results, and I wanted to see results quickly.
What I ended up doing because of that is I found myself trying to memorize and memorize right before tests so that I would perform better but then I would not do good on the final. I am like, “What the heck? I did so good on the midterms. Why did I not do good on the final?” It is because I was not building long-term memory. I was memorizing versus consolidating my knowledge and understanding it in a way that would make my brain use it for longer-term storage.
There is a big difference between short-term memory and long-term memory. Short-term memory can give you more instant gratification with the results but long-term memory is going to carry with you over the years. It is going to make you stronger, overall, academically and help you when it comes to that final. We cannot just do it in the midterms. You have to do it on the final, too.

Find Your Learning Style

The finals are going to cover information from the very beginning of your semester. You cannot neglect to understand the information from the beginning of the school year. One of the first mistakes I want to let you in is if you are not playing the long game when it comes to learning, you are not going to do yourself any favors down the road. You are just going to continue to struggle and not understand why. You will hear people say, “Are you a visual learner? Are you an auditory learner? Are you a hands-on learner? Find your style and stick with that.” I did that. I thought, “I do not like reading. I have issues reading. I have issues comprehending reading due to my dyslexia.”
I always saw people read to study. I did do that quite often, which did not get me anywhere. It caused a lot of frustration. I felt like I was spending twice as long doing everything to get the same comprehension, and it still was not there. I was like, “I am an auditory learner. I need to listen to everything.” I still enjoy auditory learning. I love podcasts because I love listening and learning. However, there is so much good stuff out there. I hear them and I am like, “I want to remember that. It is so good.” The next day, I am like, “I cannot recall that.”
It is frustrating. I told myself at the time I heard it that I needed to remember this, and then when I tried to recall, even the next day, I was like, “I can’t remember it.” It is frustrating to me. I have heard so much amazing stuff on podcasts. I am a big podcaster. I have my own show and have taken such a small chunk of that. It does not mean it is not worth my time because a small chunk plays in volumes down the road since it is a cumulative effect. It is not instant gratification. I can’t recite things that I hear all the time, I wish I could but I still know it is worth my time to listen to it.
Here is the thing. I am a good auditory learner but that should not be the only way I learn because, as I said, I still do not have the recall that I need to take a test on something that I listened to the very next day. I need to write things down. I do know that. I do not like reading but I do still need to read a little bit. I still need to try to read for comprehension but I know that I don’t get that as well or as easily as I do auditory or handwriting my notes. Maybe my reading is still there but it is a smaller chunk of what I do. Writing things while I listen is a bigger way of me comprehending what I am learning than just listening alone.
It takes time to develop true knowledge and a deep understanding. Click To Tweet

Build On Concepts

If I combine reading with it, it is even stronger. I encourage you not to pigeonhole yourself into one method that works the best for you and only stick to that method. You need to combine multiple methods to have a good, solid study technique. Retrieval practice is more than just rereading and relistening mindlessly until you are like, “I know what is next. I have been doing these flashcards so much that I even know what flashcard is next.” Do not do that.
You are not going to do yourself any favors. Mix up those flashcards, take a break, go to a different topic, and then come back to your original topic or maybe pick three topics. Do an hour of each and see how you can build and expand your knowledge by doing something called interleaving that allows you to connect pieces as you go.
Learning some pharmacology after you studied some physiology and understanding how positive inotropes work. For example, I like atrophying but then understanding the physiology process of what it means to increase your heart rate. What does that do for your cardiac output? You need to be using both types of information to build an understanding of that pharmacology with the understanding of the physiology behind it. It will give you a more solid foundation to truly understand atrophying and how it actually works in your physiology process. It is not, “Let’s study pharmacology and memorize the mechanism of action.” To have meaning in your brain, you have to be able to have it relate to something.
All knowledge is built upon old knowledge. You do not come in and understand how to code a computer. You have to start at the basics and build up to that. Anesthesia school is the same thing. You come in with a basic understanding of pharmacology and physiology, and you build on it every single day that you are in class. A lot of times, students will explain that they felt they are drinking from a fire hose. The reason why it feels like that is because you are still stuck in trying to memorize things versus building on things.
The more you build on concepts, the less it is going to feel like you are drowning in the amount of information. Do not get me wrong, it is going to be a lot but you will be able to lessen that burden by having an understanding. It is not going to feel like memorization. It is not going to feel overwhelming when you can easily recall something because you can relate the two subjects and understand how they work together. The same thing goes when you are taking a test. For example, when you get a test question, you are not sure about- I used to practice routinely reading a question and trying to answer it before looking at the answers.

Active Recall Process

The reason why I did that, I didn’t know this. After reading this book, it made me a stronger learner because I had to work hard to recall this active recall process.  I had to think and think hard to pull the information out. By thinking hard and having to be effortful, it was hard to think of all the stuff and come up with a brain dump before I looked at the answers.
It caused effort, and that caused me to learn that information more solidly. Sometimes, it would work out in my favor after I would do that, mentally recall these things that I would think could be the answer to this question. I would then look at my list of possible answers and see my answer and be like, “I knew that.” Other times I would look at my list of possible answers and be like, “I do not know this still, even though I just did a brain dump.” When that would happen, I would be like, “There is clearly something I am missing. There is clearly something I do not know. Let’s come back to it.” I would continue on my test.
You cannot do this on boards. This is a technique that I would practice during school when I was taking tests. What it served me later on doing was it helped me connect the pieces. I had to do it less as I progressed in the program. I would potentially read a question later on that would jog something in my memory that would connect to another question that would allow me to pull out that information to help me make a better-educated choice on the answer to that question.
I know that was confusing but essentially, it was allowing me to connect two pieces of information to come to an educated guess on something that I did not know that well. Another thing that I want to point out to you that you need to be doing is you need to be assessing yourself and what you know. One thing when you are studying, especially the amount of studying you are going to be doing in school, is you are going to eventually become this optical illusion, meaning you are like, “I am good. I got this. I feel solid.”
You take a test and are like, “I just got rocked.” It could be the mid-year final again. Maybe you thought you understood all this stuff all along but you weren’t connecting the pieces to allow a deeper understanding that would allow you to recall information longer-term. Essentially, I encourage you to quiz yourself to understand what you do not know, meaning you should always be assessing what you do not know and what you do know. That way, you can make educated guesses with a better, more accurate reflection of what your competency is on a certain particular topic.
One thing that I did not utilize as much as I should have but I did and was always extremely helpful was quizzing myself, whether that is through a study guide, whether that is in a group setting or on my own. My husband helped me a lot of times and would quiz me on certain things. I would give them a sheet of paper and say, “Ask me questions and mix it up.” What would happen is I would be studying a study guide and start knowing the order of the questions. I studied it so much. You have to mix it up. You can’t mentally prepare for what you think is next because you have studied it so much. You have to throw yourself off a little bit.
It is like when you are learning a skill. Think about it. You are in a simulation lab. You learn how to do epidurals, and there is a step-by-step process. Now, what if they tell you, “Go backward.” How easy is that? That is a little bit harder. “Start at step three and then go forward from there.” If you were to force yourself to do this and think about, “What is step three when I want to start at step one?” it is a little bit harder to do that.
It’s like it would be hard to start at the alphabet in the middle and go all the way to the end or be hard to recite the alphabet backward than going forward. You have practiced forward so many times. It is much harder to recite it backward and much harder to pick up in the middle and go forward or middle and go backward.

CRNA 39 | How To Study Effectively

How To Study Effectively: All knowledge is built upon old knowledge. You don’t just come in and understand how to code a computer. You have to start at the basics and build up to that. Your school is the same thing.

You have not rehearsed it. You have not practiced it as much but if you did these things, you would have it down. You would know it, and then therefore if you get in a situation where you are able to be more adaptable and flexible with your knowledge, you can look at it from different viewpoints. Mix it up a little bit, and learn it in different ways.
You do not see results as quickly. Let’s say you learned your epidurals in clinical. You went and did your rotation. You felt like a rock star. Three months have gone by, and now you are in your open-heart rotation. “The one heart that was on today got canceled. Let’s go take you up to OB.” “It has been three months, and I have not done it in a while, and I have not practiced it.”
You are going to feel rusty and sloppy. When you had it three months ago, and you were routinely practicing it, you felt like a rock star. It is because you have some forgetting going on. However, you experience that stress, that emotion, that effort of trying to recall information you had learned three months ago; going forward, four months later, when they do this to you again, you are sent back up to OB. You are going to feel way more comfortable because you now have forced that active recall.

Even though it does not feel good, it does not feel good to be put under that pressure, that stress you are going to hear that you are going to get “pimped” in clinical. All that means is you are going to get asked questions. Sometimes the pimping can occur during high-stress moments, meaning you are in the middle of manipulating the airway, and they are pimping you on, “What is your minute O2 demand?” Meaning, how much does your body utilize O2 every minute? You are like, “I do not know. I am trying to get this airway. Can I at least get through this task before I try to answer that?”
Even though it seems harsh and mean, if you were to be able to do both at once, you are going to solidify that knowledge because you have used a lot of effort to recall that knowledge. It puts you under some pressure. You tend to remember those moments and pimping. You tend to learn that way. Old-school thought was to pimp to help students learn but it has turned into what is perceived and can be used inappropriately as more bullying. In the right way, it is a good thing as long as you do it in the right way. We are all humans. We all have our own ways, and some people don’t do it the right way and come across as more like a bully.
The idea is to make you actively recall and have it be very effortful to help you remember it. Ultimately, to help you be a better practitioner, do better in your classes, and all other things. I want to point out that as you go through your training, you are going to notice when you are put in these high-stress situations and forced to recall things. Down the road, if a similar situation happens, you are going to have an easier time now recalling that information because you have already had to use some force to get it out before.

I wanted to interrupt this episode with a quick win for you. I bet you are wondering, “How am I ever supposed to know it all? How am I supposed to be prepared for the interview or even understand how I am supposed to tackle CRNA school?” Maybe you are a student nurse still and you are like, “There is so much to know, and there’s little time to know it all.” You are spending hours doing research online, trying to find all of the helpful pieces of advice you can find.
I have one ultimate resource for you that has been compiled over the last number of years from various students from across the country on resources they have used that have helped them along their journey through CRNA school. This includes YouTube channels, podcasts, apps, books, you name it. Pause this episode and grab your copy of the Ultimate Resource Guide. Now back to the show.

Take A Break

Those are some ideas I want to put in your guys’ heads around studying and utilizing testing and quizzing yourself as a way to gauge how much knowledge you are gaining from your studying. Also, know when you need to take a break, you can’t learn when you are fatigued. When you are fatigued, you are not going to be able to take new information. A huge problem with students, especially new anesthesia students, is they try to study when they are super tired. There is some research out there that looks at how effective studying is with certain temperatures, with lighting, whether you have eaten recently or whether you are hungry or not hungry, or how much sleep you have had. Sleep has been a big factor in how well you can consolidate your information.
If you lack sleep, if you are going on no sleep, and you are trying to study, you are going to have less ability to consolidate the information you are taking in. You are going to get less gains out of it. It does not make any sense to study tired. It is better to go to sleep, get up early and start taking in information than it is to try to study while you are tired.
One thing that I also did routinely in school, I did not think about it at the time but I used to love studying right before I went to bed. So much so that I would wake up with highlighter all over my sheets. Our bedsheets were streaked with highlighters because I would fall asleep with the book and then roll around with my highlighter all night. I did not know it at the time but doing that helped me recall it way better.
Something about going to sleep right afterward, that information I studied right before I went to bed, though it was not usually a lot of information because I was tired, would sink in. I would study a small chunk of information, not even a chapter’s worth, a couple of pages, something that I knew I wanted to brush up on. I would get a few pages in and be like, “I am done. I am tired. I am going to bed.” That information stuck with me but I did not try to force myself to stay awake and keep studying because then that would not do me any good but I definitely read to where I fell asleep, and then I was done. That is something that you can think about doing as well.
I want to point out too, a lot of times, a mistake that people have used in their undergrad years, which may have served you well. Maybe it was not as much information that you are going to get slammed with in grad school. It was the cramming technique, meaning you would cram on study guides before a test. You did this on repeat. You were not doing yourself any favors long-term because you were not building those connections.
Learn to take a break. You can't learn when you're fatigued. Click To Tweet
You were not building long-term memory. Even same with mass practice, you can practice a hit on your tennis racket over and over. You are going to feel like, “I got this down. I am able to do it.” Three days later, you are not going to go to do it as frequently as you were doing it the other day because you have forgotten a little bit. You are going to have to reteach it or relearn it a little bit.
It is good to relearn something. It is good to allow yourself to forget a little bit and go back to something. Do not cram and never return the information. You need to study in a way that you consolidate and understand, then return the information after you give it a few days’ rest. It is the same thing if you are writing an essay and that first copy, that first proof, you are doing a brain dump.
You are getting all your ideas out. You are trying to organize your thoughts. If you go back a day or two later, you are like, “I could totally change it up a little bit. Now I have even more insights on this.” You have had time to let it soak a little bit, and now you have even more to add to it and more organization to make it more clear, concise, and prettier.
The same thing that goes for studying. You can learn something one day and are going to feel sloppy. You are going to be like, “I am so unorganized. I do not understand at all. How is it all going to make sense?” Give yourself some time to digest all the information and go back a day or two later. Try to make yourself recall what you learned, and then try to refresh yourself. Repeat this process over again, allowing yourself some time in between studying topics and then practicing the recall because, over time, you are going to get better and quicker at it.  You are not going to have to use as much force to recall it.

Know What Works For You

Something being difficult to remember is a good thing in a way that will help you recall it even faster and stronger and make it more durable down the road.  Some things to point out, though. As much as I say, “Effort creates long-term memory.” Struggling, trying to study, and reading does not necessarily help you. Back to the whole knowing what works well for you. I am not saying that if you know this method does not work for you to do it all the time. I want you to try to explore that but I do not want you to be closed off from trying different methods because you need a blend of a bunch of things to aid in your success and studying.
For me, associating things with emotion or other memories that I have, even if it did not make that much sense, I try to do it. If something was red, it was bad because the devil is red. If something is sick, it means it is sick. It means it is bad. Icky is sticky. If I could tell you what is in my brain, you would be like, “Jenny, you have problems.” When I was studying, I would try to relate various terms that created an emotion in my brain that made it sound good or bad, evil, happy or sad, or relate it to something else. I knew that helped me recall it later on. You can play with it. Make acronyms, mnemonics, and those types of things.
If you do flashcards, great but make sure you mix it up a little bit and don’t memorize the pattern because you are not going to be challenging yourself as much. When you are studying, and things get easy, I encourage you to say, “Do I need to change it up?” When I was studying for boards, I remember being like, “I do not know if I am memorizing the content, so I know the answers or if I actually truly know the content.” It was frustrating for me. I had a board prep thing that I had bought. I had been through it three different times over and over to where I was like, “I do not know if I know this information or if I have not memorized it by now.”
I went and bought a separate board prep that I had never done. It was hard and challenged me like I knocked my socks off hard. Overall, I did good. Even though it was hard but it helped me pinpoint areas where I was a little weaker in. It also forced me to see something I had never seen before and be asked questions in a different way that challenged my recall. It was good to mix it up a little bit and challenge myself in a way that I had not been exposed to before. That helped solidify my board prep and whether I was ready to take boards. It is changing it up and trying something a little bit different.
It helps to understand whether you work well in group settings or on your own. I like group settings. However, sometimes it can be more of a distraction than helpful because you start talking about other things. You are not focused on the work. Be selective in who you pick to do this, and make sure you are all just as serious about it, so you make sure your time is used wisely.
Quizzing each other was an awesome way to study. We would study that way in the car. We had to commute to class for a couple of hours. It is such a great way to study. It helped solidify my learning. Also, when you study with other people, you get to hear their rationales as to how they understand the concept, which could be different than yours.
When you are reading material and reading one way to understand it, I encourage you to use multiple textbooks, especially if you do not understand something. I would have all my anesthesia textbooks and hit them all. If I had a topic I wanted to understand, I would look at what Bearer said and what Nagelhout said. I would compare all my anesthesia books to learn one topic because they all had something a little bit unique to it that tried to help my understanding as well as your notes. Asking your classmates to explain something to you and how they get it could be very helpful for you in your learning. That covers most of my topic.
One last thing I want to point out is that when you experience test anxiety, this happens quite frequently in anesthesia school because you feel like your life is riding on the line. You feel like this is make-or-break. If you do not do well in school, you get kicked out. All this hard work is going to be for nothing. I know, and you know, you work your butt off to get into school.

Test Yourself Before The Big Day

I get the immense amount of pressure that you are under but I encourage you to check yourself because you have to get that right in your mind. You are going to hinder yourself and your ability to display your knowledge when you have this fear lingering over you. Address it head-on, deal with it, and try to come to terms as to why this is and why you feel this way. Keep testing yourself on your own before it is the big day.

CRNA 39 | How To Study Effectively

How To Study Effectively: As you go through your training, you will notice when you’re put in high-stress situations and forced to recall things down the road; if a similar situation happens, you will have an easier time now recalling that information because you already had to use some force to get it out before.

Do not wait until your actual real test day to test your knowledge, test yourself, and then hit your weak points. That will give you more confidence going into your tests, knowing that you have been able to test yourself, test yourself well and pinpoint your weak points. It will allow you not to feel as anxious about the test. Also, see if you can review your old tests.
A lot of times, you have to do this with the professor in the room. They cannot trust any student to go review a test because it is too tempting to take pictures and screenshots and things like that these days. Some programs may or may not allow this but if they do allow it, it is a great way to find out what you do not know so that you can improve upon it.

Ask For Help

If you do this, that in itself will allow you to feel less anxious because you are like, “I know what I need to improve upon. Now I know what actions I need to take.” Do not be afraid to go ask for help. Be proactive in your learning. Be someone who seeks out resources before it is too late. Do not wait until you have a bad test or feel so flustered about a topic that you want to cry. Go get help early on when you need some help understanding and meet with your professor or students ahead of time.
Try to gain that understanding prior to it causing so much anxiety for you to where you are fearful of not doing well on one of the tests because of it. I hope you enjoyed this episode. There is going to be more to come. This is a common topic that people would love to know about. I have more to share with you but I am going to break this up into different sessions. Have a good rest of your day. We will see you next time.

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