PPD

Study Problems among Medical

Students
By: Dr. Madhumita Sen
Personal and Professional Development
MBBS Program
Session 2015-2016

Learning Objectives
On completion of the lecture, the student
should be able to
1. Identify student academic stressors and
explain the common problems faced while
studying
2. Apply the solutions to address the study
problems
3. Develop personal study tactics and goals
4. Learn personal learning style
5. Learn the importance of emotional learning.

Let us emancipate the

student, and give him
time and opportunity for
the cultivation of his
mind, so that in his
pupilage he shall not be
a puppet in the hands of
others, but rather a selfrelying and reflecting
being.
SIR WILLIAM OSLER

Student
Academic
Stressors

 The decision to become a

physician represents an
important commitment.
Although medical school
training provide the
knowledge and technical
skills needed to practice
medicine, they do not
necessarily help anticipate
the effects medical
training have on the
person.

Specific Stressors in the Basic

Science years
Time pressure
Emphasis on course examinations
Competition for grades and class
rank
Financial problems
Amount of rote memorization
Limited time for recreation and
exercise
Strain on social and intimate
relationships
Loneliness

 Erik Eriksons psychosocial

theory of development
describes early adulthood as
a time for strengthening the
identity that is usually
attained during adolescence.
This identity includes
individuals establishing
themselves as independent
people, separate from
parents.
In addition, young adults
must pursue vocational
goals and attain a capacity
for intimacy.

 The medical school

environment, however, may
create further stresses.
The seemingly limitless
material to be learned and
the fierce competition can
decrease peer support and
leave little time or energy
for establishing intimate
relationships.
Other stressors include the
tedium of rote
memorization, loneliness,
and fear of failure.

 Im not
smart
enough to
be in
medical
school.
What do you
call the
person who
Graduates
last in his or
her class
from medical
school?

Specific Stressors in the

Clinical Years
Some students who have been
exceedingly capable in the basic science
classroom find themselves faltering as
they move into the junior year and
confront the realities of clinical medicine.

 In the cancer ward, they face

the issue of imminent death; in
the paediatric ward, they see
children with congenital
defects die of kidney failure;
In emergency rooms, beautiful
young 12-year-old children
come in with missing limbs;
and
In the surgical wards they may
interview people their own age
paralyzed after being shot in a
senseless $10 robbery.
MARLENE M. COLEMAN, M.D.

Specific stressors
Interpersonal conflicts with faculty
and fellow students
Fear of increasing responsibilities and
the potential consequences of bad
decisions
Death of patients
Dealing with chronic or terminally ill
patients
Fear of infections such as AIDS
Discomfort in discussing personal
issues
Discomfort in performing physical
exams

Levels of
Stress
One set of
investigators
found that stress
was highest at the
start of school and
just before
examinations and
lowest midway in
the third year.
The most common
stress pattern is

Type A Personality

Many medical students exhibit a Type A

personality style characterized by
competitiveness, hostility, time urgency, and
excessive devotion to work.
Type A personality style was documented in a
survey of 100 randomly selected physicians
that found that only 10% regularly took time
off to relax.
Only 11% took vacations that were not linked
to professional activities.

Lack of sleep

The hectic schedule of students is

affecting their health and life style.
Numerous studies conducted within the
past decade have analysed the
deleterious effects of sleep deprivation.

Ann Med Health Sci Res. 2013 Jan-Mar; 3(1): 5154.

Motivation
For some college students,
limited motivation is a major
concern, especially if the career
choice was not their own.
Unmotivated students are less
inclined to study or to turn away
from social pulls to get studies
done.
Additionally, students who lack
motivation may quickly develop
a feeling of helplessness once
they experience failure.

Not Enough Time! (Net*

syndrome)

The internet is hugely addictive.

I will just finish this chat/update
then get on with my studies.
Time-stealers can seem
important!
Studying in a rush means you
cannot remember when the
time comes.

Test Anxiety
When you think about an important test,
what are you afraid of? The obvious answer
- being afraid of failing or performing badly.
Test anxiety affects many people of all ages
and intelligence, and its symptoms are
rooted in our biological "fight or flight"
response
Fear often causes us to see things
differently from reality.

 Some kind of physical

or emotional anxiety is
common to most test
takers.
Some people live in
dread of a moment
when their brains "go
blank."
Others experience
gastrointestinal
problems, headaches,
or profuse sweating.

Tips for
Successf
ul
Studying

 Learning to study effectively ranks high in

importance for college students.
Up to 33 percent of incoming freshmen dont
know how to study effectively.
Unfortunately, many students dont realize that
they dont study effectively, and they assume
that the study habits they formed in high school
will see them through college.
http://www.academicinfo.net/campus-life/
eight-tips-for-successful-studying

Set Study Goals

Set realistic learning goals.
These goals serve as the driving force to
generate and maintain the motivation,
thoughts, and behaviors
Set and use long-term occupational goals
(you want to be a doctor) and short-term
learning goals (you want to understand
this new material).

Active
Learning
College level learning requires your active
engagement. You cant just do the reading
and leave it at that.
You have to actively participate by
underlining, making notes and questioning
what youre read.
You need to connect new material to what
you learned last week to make it into a
cohesive whole.

Block off Enough Time

Your classes and studying
take centre stage.
For each hour you spend in
class, youll need to devote
two to three hours outside
of class for study.
Inability to maintain an
organized planner and to
schedule study time makes
it easy for students to get
distracted.

During Class
Attend all your classes.
Take notes, ask questions and join in discussions.
Learning requires your engagement in the subject.
If you do miss a class, ask a class friend if you can
borrow their notes.

Set Mini Deadlines

Check your class syllabus and
note when you have a big test
or a paper due.
Count backwards from that
date and schedule time each
week to study for the test or
research.
By creating mini deadlines,
youll ensure that you have
done all the work youll need
to do in time.

Take Breaks Often

Research studies show that people can
concentrate intensely for about 45 minutes at
a time.
Set up your study time so you put a good 45
minutes focus on studying, then take a 10 to
15 minute break.
Get up, stretch, walk around. When your break
is up, head back to your studying.

Know yourself
Know yourself as a learner (learning
preferences, talents, best times of day to
study, ability to match study skills to
learning task);
Know a variety of study skills and
learning strategies and how to use them.
Know the contexts in which what is being
learned can be used now or in the future.

Learning Styles
Prefere Defining
nce
characteri
stic
Active
Prefers
learner interaction
s
with others

Learning
style

Learning advice

Learn by
Group activities in
explaining to which members
others.
explain topics to
Prefer
each other.
pictures,
Finding ways to
models.
apply or use the
information.
Reflecti Prefer to
Learn by
Periodically
ve
think about developing
reviewing what has
the
connections been read. Writing
material
&
a summary of
first.
relationships readings or class

Sensin Detail
g
oriented,
look for
and trust
facts

Like learning
facts and
solving
problems
using wellestablished
methods
Intuitio Look for
Dont like
n
patterns
courses that
and
require
relationshi memorization
ps among and routine
facts, trust calculations.
intuition.

Case study
method.
Connecting
information to
real world
applications.
Finding
interpretations or
theories that link
the facts.
Using care to read
the entire question
before answering
and rechecking
work to prevent

Prefere Defining
nce
characteri
stic
Visual
Remember
learner what they
s
see

Learning
style
Like pictures,
diagrams, flow
charts,
demonstration
s

Learning
advice

Finding or
drawing
diagrams,
sketches,
schematics,
photographs,
videos. Using
concept
mapping.
Color-coding
notes.
Verbal Get most
Learn by
Writing
Learner out of
developing
summaries or
s
written and connections & outlines of

Global Learn in
learner large
s
jumps,
randomly
absorbing
material
until they
suddenly
get it
Judging Gain
:
understandi
Sequen ng in linear,
tial
logical steps

Skimming
through
the entire
chapter to
get an
overview.

Outlining
course
lecture
material in
a logical
order

Study for specific

information.
Relating the
subject to things
already known to
see bigger
picture

Note taking and

test taking. Making
mind maps.
Relating new topics
to things already
known to
Felder, R.M., & Soloman, B.A. (n.d). Learning styles and strategies.
strengthen global
http://www.engr.ncsu.edu/learningstyles/ilsweb.html
thinking skills.

Understanding Strategy
On first pass: mark spots you do not
understand
On second pass: focus on marked areas you
still dont understand,
Then:
a) Identify why you dont understand (words,
sentences, paragraph)
b) Break the problem down into parts, look at
the surrounding text for clues
c) Check other resources

Recall strategies
After the initial reading:
Paraphrase and use imagery. Try to form
mental pictures of the concepts.
Transform the material into concept maps or
networks; you recognise their interrelationships
You can code these relationships. For example,
the categories of:
i. hierarchies(type)
ii. chains(lines of reasoning)
iii. clusters(characteristics, definitions)

Strategies for
Comprehension
and Retention
1. Set the mood to study
2. Read for understanding by highlighting,
marking important points
3. Recall material without referring to the
text
4. Correct recall, amplifying material
5. Review mistakes (learn from tests)
6. Repeat , using active recall,
7. Process the information by putting the
material into an alternate form.

Concentration
management
Attitude problems: When setting the mood to
study, learn to monitor your negative and positive
self-talk along with the images created. Stop the
negative self-talk spiral before it gains
momentum.
Coping with Distractions: Then learn to control
your thinking by stopping the automatic thoughts
and thinking errors and identifying faulty thought
themes. Keep your end goal in mind.

Assistance Outside of
Class

Talking to your lecturer might help clarify

something you didnt quite understand or it
might offer an opportunity for you to
explain a concept to a classmate.
Studies show that we retain 95 percent of
what we teach others.

V
S

Study in Groups
Teaching and Learning in small groups has a
valuable part to play in the all-round
education of students.
Helps in assisting students to clarify their
attitudes to and ideas
Provides opportunities for students to receive
more immediate feedback on their learning
Encourages students towards selfdirected
and independent learning
(JAQUES D, 2004. Small Group Teaching, Oxford Centre for
Staff and Learning Development, UK)

Test Your Own Knowledge

Give yourself practice tests and write out
your answers as if it were a real test.
The act of recalling information to answer
the questions and writing it down anchors
the material deeper in your memory.
Review and test frequently, rather than
waiting until just before the midterm or
final.

Combat Test
Anxiety

Establish a consistent pretest routine.Learn what

works for you.
Learn relaxation techniques. Deep breathing,
relaxing your muscles one at a time, or closing your
eyes and imagining a positive outcome.
Don't forget to eat and drink.Your brain needs fuel
to function. Remember, energy drinks or coffee can
increase anxiety.
Get some exercise.Regular aerobic exercise can
release tension.
Get plenty of sleep.Sleep is directly related to
academic performance.

 If you panic during tests, try to think about

these steps ahead of time:
1. accept the anxiety as normal (rather than
fighting against it)
2. practice deep breathing
3. make a fist and squeeze tight, then relax
your fist and imagine your whole body
relaxing.

Tips during a
test
For multiple-choice questions, eliminate
and decide. Make an educated guess - you
have a 50% chance of getting it right.
For essay questions, brainstorm and
outline before writing.Don't let yourself
freeze up while staring at that blank essay
form. Organize those thoughts into a brief
outline, then start writing.
Keep it moving.Because most tests are
timed, it's important to pace yourself during a
test and not spend too long on any one item.

Emotions in Learning
If we were disembodied beings, pure minds
free of our messy emotions, our responses to
our successes and failures would lack
seriousness and excitement.
Like a computer, we would have goals and
succeed or fail to achieve them.
For embodied, emotional beings like us,
however, success and failure do matter.

 Unless the trainee stays emotionally

involved and accepts the joy of a job well
done, as well as the remorse of mistakes,
he or she will not develop further.
(Patricia Benner, 1984).

 In general, if one seeks

the safety of rules, one
will not get beyond
competence.
Experiencing deeply felt
rewards or remorse
seems to be necessary
for the performer to
learn from examples
without rules.
The more the beginner is
emotionally committed
to learning the better.

Nothing will sustain you more

potently than the power to recognize
in your humdrum routine . . . the true
poetry of lifethe poetry of the
commonplace, of the ordinary man,
of the toil worn woman, with their
joys, their sorrows, and their griefs.
SIRWILLIAM OSLERS advice to medical students (circa
1905)

Summary
1. Medical students can have study problems in their
preclinical years due to the volume of study, fear of
failure and the loneliness of leaving home for the first
time.
2. During clinical years, confronting the realities of
illness and death play a role in causing stress. Fear of
exams and the workload can interfere with studies.
3. Proper time management, good study tactics,
motivation, group study and relaxation techniques
can help combat study problems.
4. Emotional involvement and a sense of commitment
to the chosen career are good ways to stay on track.

References
Behavior and Medicine4 Rev Upd Edition by
Danny Wedding, Chapter 6, Special Problems of
Medical Students, Darlene L. Shaw, Danny
Wedding, Peter B. Zeldow, Nancy Diehl.
Ann Med Health Sci Res. 2013 Jan-Mar; 3(1): 51
54. doi: 10.4103/2141-9248.109488
http://www.academicinfo.net/
http://www.testprepreview.com/test_anxiety.htm
http://
www.mayoclinic.org/diseases-conditions/generali
zed-anxiety-disorder/expert-answers/test-anxiet
y

Any Questions?
Thank you