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Academic Educator Dr. Jim Culhane Debriefs After Taking the STATMed Study Skills Class

Host Ryan Orwig is back with Dr. Jim Culhane, Assistant Dean for Student Academic Success Programs and Professor of Pharmaceutical Sciences at Notre Dame of Maryland University School of Pharmacy. In this new miniseries, Ryan and Dr. Culhane debrief from a recent STATMed Study Skills Class where Dr. Culhane participated as a student. In this new series, they dig into the top 10 takeaways from the 10-day class. They also discuss the difficulties some students experience with learning in med school and related fields.

“The students in this cohort and again, from what I’ve heard from what you’ve said, the students in your cohorts or classes are very, very bright individuals. I was very struck by their level of motivation, their investment in medical education, their intelligence, just they’re great students. I mean, as a teacher, I’d give my right arm to have any one of these guys in any of my classes because I know they would knock it outta the park, and yet they all had this thing in common where they struggled, they fell, and so they had that kind of shared experience together.” – Dr. Jim Culhane

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Transcript

Welcome to the STATMed podcast, where we teach you how to study in med school and how to pass board style exams. Your host is Ryan Orwick, a learning specialist with more than a decade of experience working with med students and physicians. In this new multi part series, Ryan and Dr. Jim Culhane, Assistant Dean for Student Academic Success Programs and Professor of Pharmaceutical Sciences at Notre Dame of Maryland University’s School of Pharmacy. Sit down to debrief after attending the STATMed study skills class alongside struggling medical students. Dr. Culhane digs into his top 10 takeaways from the class.

You’re one of the few people that I’ve ever met or encountered that has spent and dedicated their whole career to thinking about study methodology in learning and developing and improving and redeveloping methods that are extremely in tune with the needs of your clients. That really struck me.

Welcome to the STATMed learning podcast, where we talk about studying, time management, and test taking in med school, on medical boards, and in related fields like veterinary medicine and pharmacy. I’m Ryan Orwick, a learning specialist and creator of STATMed Learning, and with me today is my friend and frequent podcast collaborator. Dr. Jim Culhane.

Hello, Ryan. How are you?

I’m doing well.

Thanks again for having me on the podcast. I appreciate that.

Of course. Yeah, quickly introduce yourself.

Yes, so for those of your listeners that haven’t heard our exchanges before, my name is Dr. James Culhane. I’ve been in pharmacy education for just about 25 years. I’m currently a Professor of Pharmacology and Assistant Dean of Student Academic Success Programs at Notre Dame of Maryland University School of Pharmacy. I’m also the author of an upcoming book entitled “Evidence Based Learning Strategies for Student Pharmacists”, which is coming out this fall through the American Pharmacists Associations publishing wings, so really excited about that, and hopefully we’ll have a chance to talk about that at some point in the future.

Absolutely, and today, what we’re gonna do is we’re gonna talk about what it’s like when we let Jim take our STATMed study skills class. The study skills class is like the big platform that we offer. We offer a few different platforms, but the study skills class, it spans eight to 10 days, a very structured scope and sequence where we take a group of students and we redesign the way they study, the way they manage and maximize their time, and the way they take boards style tests. The main group of the students are gonna be med students, usually in the first two years, could be board prep, could be third, fourth year. You’ll also have veterinarians. You’ll have PA students, maybe some PharmDs, and students in other related fields in the class, and we’ve never done this before, but we just completed the class, and Jim was a full on student in this class. Now, look, this is not something that’s an open invitation to other people who are not students. This was a very special circumstance. Jim and I have been working together for almost 15 years now. We have a long history together. He’s got the book coming out, which I thought would be really interesting to sort of connect how he sees things from the evidence based side and the coaching based side versus how we look at all the stuff big picture. But yeah, we don’t offer any platform for faculty development or for other learning specialists as of yet. And you know, Jim, you and I have talked about this a lot. I mean, there’s certainly a need there, but I don’t know why. I mean, I’m a control freak, first of all, number one, I don’t want somebody teaching our methods with our name on it if they’re not doing it to the standard to which I aspire, and I think you can understand that, right?

Oh, absolutely. I mean, I certainly can appreciate that, and we’re just very grateful for the opportunity to take this course, like you said, you and I have known each other for a long time. Prior to the class, I would’ve said that I am modestly familiar with your approaches and things that you do only because of lots of conversations that we’ve had. I send many of my pharmacy students to take this course that are struggling in our curriculum, and you’ve also worked with us at our school before. So this was a real great opportunity for me to take a deep dive into the STATMed learning process. And in some ways see what my students are experiencing when they take this course and what other students are experiencing as well.

Yeah, I think it was probably extremely eye opening for you to meet some of our main population, these highly intelligent, super motivated medical students and those in the related fields, but the majority of the group are med students, where they’re just so smart and hungry and frustrated, and just so eager to learn these skills and to tear down and abandon their old ways and to bring all these new skills on board. So I think, and we talked about this, you wrote a blog post on this. You guys can find a blog post that he wrote about his top 10 takeaways from the experience. So we’re gonna sort of just use that as a framework to sort of bounce down, like Jim’s 10 main takeaways from the experience, and then we’re gonna extrapolate and ping pong through all that stuff, but that’ll be sort of the way we go through this. Is that fair?

I think it sounds like a great plan, Ryan, and I think to kind of start off a little bit, if I can have a minute or two, I’d like to talk about the students that I took the class with, cause I think that was something that was really fun for me and interesting. As you pointed out, the students in this cohort and again, you know, from what I’ve heard from what you’ve said, the students in all of your cohorts or classes, very, very bright individuals. I was very struck by their level of motivation, their investment in medical education, their intelligence, just they’re great students. I mean, as a teacher, I’d give my right arm to have any one of these guys in any of my classes because I know they would knock it outta the park, and yet they all had this thing in common where they struggled, they fell, and so they had that kind of shared experience together.

Yes, and it’s easy for me to maybe forget how lucky I am to have these students. It’s again, you have a group of people where you tell ’em to jump 10 times, they’re gonna jump 20 times. You’re gonna say, “I want you to struggle a little bit, really wrestle with it.” They’re gonna go the extra mile. I mean, you’re a coach getting these raw athletes, who no one’s ever really taught ’em the mechanics of how to play the game and they’re hungry and they’re eager, and it’s a fun experience to really have these motivated adult learners.

Yeah, and they bring so much energy. I mean, I think that was something I will just say in general, Ryan, every day when I was done with the class, I was exhausted, you know, mentally and physically, and not exhausted in a bad way, but just the energy that came off of this group and the work and growth that happened that I could watch as a teacher, it was kind of interesting when I was taking this course, I was wearing a bunch of different hats for myself. I’m a student in the course. I’m also a professional teacher. I mean, that’s what I do and I’ve been doing my entire career. So I’m watching these students as they gain these profound insights and learn these skills and grow, and I’m like, “Wow, this is really amazing.” And it really energized me and also thinking about, in addition to that, how I can better help my students as well too, because that’s, I mean, as an academic coach, and the work that I do on a daily basis, that’s really what gets me up outta bed every day and into work. I love to help students that are struggling and to see them come in and come in and say, “Hey, Dr. Culhane, I got my first A in my pharmacy school.” And I mean, you see that as well too, and it’s just incredibly rewarding.

But the key for us, I think for any instructor at this level is like, when somebody comes in, they say, “I’m struggling” in this specific way. To then be able to say, are we able as the instructor to help to understand the pattern and be like, “Hey, actually, I’ve got an answer for that.” And then what this allows is the time and the space and the structure to intervene with those problems. Now, I’ve done a lot of interviewing and screening before the students come in. I mean, we have limited spots in these classes, and for example, we still are halfway through the summer right now, and our classes are full. Now will we be able to add another one? I don’t know yet, but we do a pretty, you try to screen it and get the right people in there. So you have an idea ballpark where they are, but when they come in and they have very specific concerns, it’s just exciting to say that, “Oh yeah, I’ve got this.” And then, they’ll be asking questions on the lead up, like, “But can you do this? Can you address this?” It’s like, by and large, the answer is yes, yes, yes. Or it’s like, “Okay, I know what your concern is, but you don’t even have the vocabulary to ask really the right question just yet.” And I’ll tell him, like, “Let’s just talk about that on the back end,” or “We’re gonna find out that the question you’re asking is not as big a concern as you think at first.” So, but yes, I mean, I was very pleasantly surprised by what you got to see from the student side of things, which was just.

And I will also say too, a couple of other observations cause you’re right, I think another thing that was really, there were so many observations I made about this group. I mean, I think the other two things that came out very, very clearly to me, number one, each of these students in their own way, unfortunately carries a ton of guilt and shame about where they’re at. I mean, these are all students that are extremely bright. I’m sure up to this point in their educational careers have done extremely well. And they got chewed up and spit out by an educational system that doesn’t really know what to do with them. I mean, I think there’s a profound brokenness in medical, and when I use the term medical education, I’m gonna say health professions education, where we just, they’re programs and institutions are really struggling with how to deal with students that are not successful in their programs and, as a case in point, I was just appointed to a national committee for the American Associations of Colleges of Pharmacy that was tasked over the next two years to look at retention, progression, and academic success in pharmacy schools across the country. Now there were 300 volunteers for this committee, Ryan, and there were only six or seven slots. When they sent an email saying I made it, I was really so excited because this is an area that I’m really, really passionate about and really interested, but the fact that you have a national organization like this that’s going to invest two years of time and get the very people in there, in the academy that are invested in this topic speaks volumes to me.

So what I’ve seen over the last 15 plus years is obviously people on the administrative and the teaching side of all these med schools, PharmD schools, veterinary schools, they know this is an issue. I mean, everybody has concern about it, but I don’t feel like, they don’t know the answer. I’m not saying I know the answer, but we’ve seen a huge uptick in the hiring of academic support folks, learning specialists, people to support students in the run of play at med schools. That’s grown tremendously over the last 10, 15 years, but there’s not a singular place to go and get the right education to be good at that job.

Right, and I think we’ve talked about that before. I mean, when I assumed this position at Notre Dame, one of the first things that I did was to look for, we had been talking for years about hiring a learning specialist to come in and work with our students, but this whole term, what is a learning specialist? Is there a degree program out there for it? Is there certification? And I mean, I did a ton of research cause I’m like, “I need to be able to get some sort of education in this area.” And there’s just a huge void in this area, and I think what I’ve seen is that people will call themselves learning specialists and they have very, very different backgrounds. And I will say even after all the research that I’ve done in writing and work with students, I mean, I’ve got thousands of hours accumulated already over the last three years coaching students, I would not refer to myself as a learning specialist. I’m not even sure, I don’t have a master’s degree in education or a doctoral degree in education, so I struggle with that for sure.

It’s a big umbrella term. So, like my background is I have a master’s in teaching and learning and leadership with an emphasis in reading. So I look at all through the filter of the science of the reading brain, because reading and learning are tied in, but what I’ve seen over the years, and we might have already talked about this elsewhere, but is that, and it makes sense, it’s just not as effective, like number one, the people that are hired are dealing with, the learning specialists are dealing with an extremely high number of students, and so they are patching holes in the run of play at high volume. That’s a very important job, and it does handle a bandwidth of issues, but I think that part of the problem is setting an expectation of scope of what you can do in those structures, in those whole patching versus whole rebuild. I think that people in those positions are better at whole patching, and I don’t mean that in a bad way. I mean, if your boat’s sinking, you patch the holes, but we are on the other side of it. Whenever you want to take a break, send them out either on the summer, on if they’re on a leave, over the December break, send them to the class when they are not enrolled in classes for those 10, 15 days. Do something like the class where we do a complete reeducation, rebuild, reset, and send them back out. There’s just two different roles. And I think part of the problem is it’s all lumped together as one, but then the other thing I see is that schools, they feel like they have to do something, right, so I feel like what’s happening is it’s a constant rebuild, reshuffle of curricular design. It’s like, “Oh, we got a new curriculum. That’s gonna solve the problem. We got a new curriculum that’s gonna solve the problem.” I don’t doubt the curricular improvement is a piece of the puzzle, but it’s not always the solve, and this is where we come in and it’s like, “Well, why don’t we do this? Why don’t we take students, put them in our STATMed study skills class” Students that, and again, it’s not for every student, but it’s probably a significant percentage of the overall body, maybe it’s 30%, maybe it’s 40%. I don’t know what it is, but you take these smart, motivated, hungry students who say, “I don’t know how to best learn under the fire hose of the speed, volume, density equation” and say, “Let’s rebuild their study skills and their understanding of learning philosophy and learning theory for them as it applies in this arena and equip them so that they can go out and they can thrive in any arena, no matter what the curricular design is, no matter what the content is under that scope.” So that’s kind of where we are with this class, and again, I think you saw that where our students came in and we had students who were rising between first and second year. We had students who had failed in repeating first year, repeating second year. We had students, like a physician who was trying to get certified in the states through the US MLEs. We had a veterinarian student, we had a PA student, so we had a nice cross, like a repeating PA student, so we had a nice cross section.

And I’ve never had a chance to work with students from those health professions discipline, so that was really exciting for me to be able to work with them and to hear their stories, and to, like I said, see the impact that this method will have on the learning.

Well, and again, there’s so much conversation. We all get to know each other so well in the class, and that is a very specific, intentional part of the design of the class. It’s like a big round table discussion. It’s not like we’re in some lecture hall seminar. Did you know that that’s what was like going in?

Well, you know, I think one of the things that was very helpful for me, had we not had some of the preliminary discussions about some of the work that you were doing in revamping the course, I might have expected more lecture based type of delivery of information, but, as we talked about, you were moving more and more towards a more flipped classroom type of model where you offload a lot of the “lecture” information delivery components of it to video so that students can engage in that outside of class and then come in and really have these robust, rich conversations about their experience with those video learning modules and what they learned and how they think it can apply to their learning. The flip classroom model is really a very powerful model of learning if, here’s a big if, if your students are committed to doing the work outside of class, that’s the key. If nobody watches the video, if nobody does the homework, then it’s like cricket’s chirping when you’re working with them, and that was not the case here. Everybody was super, super engaged.

Well, I mean, they’re paying for it. You know, this is like, I’m not knocking on their door, checking on them, doing their homework. Now we have access, so we can see who did, who watched it, who didn’t, but yeah, like this is not, I’m not a motivational speaker. I’m not, there’s no grades here. These people are coming to the class, and this is again, as a teacher, as an educator, what a luxury, my students are coming in, They’re like, “Give it to me.” They’re gonna watch it. They’re gonna come in, and right, that’s what Dave and I are calling brain time, what people really want is our brain time, our accumulated expertise, understanding the patterns and the experiences and the stories that tie into the individual skills that we’re teaching in those on-demand lectures and then how they start to connect together and how those pieces are mixed and matched and modularized so that each student can customize their own sort of learning sequence. So one of the big things that we’re doing through this year and moving forward is we’re flipping the classroom, spending about as much time in the classroom as we have historically, but now they’re getting all this information on demand so they can watch it up front. They can re-watch it, they can revisit it, and then we get to talk so much more about it. Dave and I both said that in our first classes we taught with the flip classroom this year, we felt like we knew these students better after day one than we usually do by day four or day five, and that’s what’s so fun about this. Fun is an important word here. Fun meaning rewarding.

Oh, absolutely.

Insightful connect, cause fun is connection, understanding who they are, where they are, where they’re coming from and how they’re starting to bring the skills on board, so it’s this round table discussion. I sit at the head of it or David, or maybe eventually you sitting at the head of these tables as we’re teaching these classes and we’re making sure, it’s like the hidden curricular design. We’re making sure that our key teaching points and objectives are met for the day, but if the students reveal it great, then if not, we’re there to make sure that happens. But then there’s just so much other stuff that happens. And I think part of that is the being seen part in each student, to understand that they’re not alone. You talked about the shame they bring for struggling. Maybe it’s shame for not knowing the best way to study, which is a shame. We shouldn’t feel this way. And by seeing that there are other people that have very similar thoughts and experiences and emotions, I mean, that’s very healthy, right?

Yes, absolutely. I think so.

Yeah. So let’s maybe start hitting some of these points. So the first point you had was methodology matters. This is one of my favorite catch phrases.

Yes, I shamefully borrowed some catch phrases of yours for the blog post, but they speak well. I mean, they’re catch phrases because they capture the essence of what you’re talking about.

Yeah, and what’s great is whenever my students, of which in a way you are in this regard, when my students throw my own vocabulary back at me, either the names of the skills or a catch phrase, like methodology matters, or when I snowplow versus helicopter, like, “Oh, I was snowplowing and I need to more like a helicopter,” when we talk about learning approach, like, it’s really powerful because that is part of the design and the intent with the vocabulary, with the catch phrases, with the images, with the cartoons, whatever, to empower the student with the vocabulary so that they can throw it, use it to articulate what had otherwise been vague or fuzzy, or they didn’t even know it was a phenomenon. So methodology matters, why did that resonate for you so much?

Yeah, well, first I think the reason that resonated so much for me is that I think what you have managed to achieve here with the course and the methods and the skills is profound in many different ways. I’ve looked at lots of different advice out there and I’ve read a lot of books in this area, how to help students learn more effectively. I’ve taken other courses. I’ve really tried to do my homework in this area, and I think one of the things that really strikes me about this and again, having known you for all these years, I know that this is the case is that you’re one of the few people that I’ve ever met or encountered in a book or through a book or through a course that has spent and dedicated their whole career to thinking about study methodology and learning and developing and improving and redeveloping methods that are extremely in tune with the needs of your clients. That really struck me.

Well, and only when we talk about reading and learning and studying, we’re talking only through the filter of medical education, only through the filter for our med students, our physicians, our PharmDs, like I can’t help a lawyer. I can’t, could I help an undergrad student? I mean, we’ve experimented with those things, depends on the student’s motivation. This is not how you apply for, like, if you’re doing like a PhD program, that’s not very narrow. It’s a narrow trench that runs extremely deep, and yes, my incessant need to tear down and rebuild is kind of, I mean, it’s definitely an advantage for me and the students.

It’s a real strength. I mean, you don’t sit on your laurels. Every time I talk to you, you’re tearing down a module or a component to what you’re doing and you’re rebuilding, and I think the other thing I talk in the blog post about anytime I encounter a new course, like I said, I’ve taken other online courses. I’ve read books about this, talked to other folks, watched YouTube videos, and I think anytime I look at something like that, I ask myself the kind of three big questions about a method or advice or an approach, and the first is, it grounded in the learning sciences? I mean, that’s really, really important to me, extremely important because for me as a educator, that’s how you’re gonna distinguish between just anecdotal advice and methodology that actually is grounded in the sciences and had been proven from a research standpoint. And that as a scientist, that’s really important to me.

Oh yeah, for your PhD brain, I mean, that’s where it’s at. So just cite a few things in the class that you were like “Yeah, this ties in with the learning sciences.”

Oh, yeah absolutely. I mean, it’s pervasive throughout the entire course and methodology. I mean, when I look at the learning sciences and the evidence based approaches, and like I had mentioned before, my whole book that I wrote is about these approaches and how to operationalize them for students. You have things like retrieval practice, which is also known as active recall, self testing, there’s a lot of different words for it, things like interleaving, things like spacing, and space retrieval practice, those sorts of things, you can see that the methodology is really grounded in that. And in fact, I’ve told you this before, the work that you’ve done, especially when I met you early on, really inspired me as a medical educator to do a deep dive into the educational literature. I never even thought to look there as a pharmacologist and I’m working with students that are struggling. I’m like, “Oh, wow.” It just kind of hit me like a ton of bricks one day. “Wow, there’s a whole body of literature out there.” And I felt kind of dumb about it, not realizing it before, but yeah, there’s a ton of really great research and information out there that we can draw from.

Right, but it’s funny, cause retrieval practice is woven through what we do, but even like something like space learning, space practice, like it’s not like we sit down and say, “Today, guys, we’re gonna learn how to do space practice”, right. We introduced the concept up front in our learning foundations, but it’s the operationalization, and the way to implement all that through a variety of our other tools, the tools beget and allow and unlock space learning. But it’s not like, “Today we’re talking about space learning, gang.” Right, and I think I appreciate that that’s how it’s taught because it’s so much more about the real world. It’s so much about saying like, “This is how it’s all going to work together.” And it’s cool because then the students can say to me, “Oh, well when I do it like this, I’m falling into a little bit of mass practice here, but then I can distribute and space it out and interleave it out here using tools ABC,” or like, “I can framework it here, then I can watch lecture. I can dynamic reading mark, and then I’m using my schedule and my academic study agenda to make sure I’m spacing it out,” so it’s one of the things for you. You said you had three criteria, one of which is grounding in the learning sciences, which, I’m proud to say we are, right? What else?

And I think on top of that too, I mean, it’s very clear to me the influence of you as a reading specialist and how that’s influenced a lot of the methodology, just your approach and the lens that you look through, and I think that is so powerful too, because there are not a lot of folks that I think have that lens that do what you do.

Everything that we’re talking about is reading based, right? Everything is reading from, if it’s a PowerPoint, you’re still reading a PowerPoint. PowerPoint’s a weird, unusual, weirdly evolved construct that everything’s being sort of organized around. If you don’t read that PowerPoint as well as, not as the average dude on the street, if you don’t read that PowerPoint, as well as the average person in med school or PharmD or your vet program, you’re at a disadvantage. Test taking is all reading. It’s not about the clinical performance when it comes to passing your classroom exams or your boards. If you don’t read as well in as nuanced and fluid and fluent a manner that aligns with that textual construct, guess what, you’re at risk. Does that mean you’re gonna fail? Maybe not, but maybe put you more at risk of failure or maybe you’re always scoring below what is an actual representation of your knowledge. Everything is reading at this point to me, and if you don’t read as well at that very far end of the spectrum, as your peers, you’re at risk. So yeah, everything that we do looks at things through the filter of reading, and this is where David and I met. We met way back when, in Baltimore, in the late nineties, working with gifted kids with dyslexia, and so we always talk about what makes us special. I think a part of it is like how sequential we are, step by step by step. Never making a big jump when we’re teaching a skill. for example, looking so there’s never a gap in the sequencing, like I’ve always been in these training programs. I remember they’d show you the finished product of what you’re supposed to do in the study method or any other walk of life, and I’m like, “Yeah, but how many steps did you take to get to that finished product?” Or “I’m not clear on like the gap between like phase A and phase B or whatever it might look like.” So I think one of the great things that we do is that we’re building each skill by itself in isolation, very mechanistically. And I think that does come from that background as a reading specialist, really looking for links in the chain that are broken almost like a computer code. I mean, I don’t know anything about computer coding, but I imagine if you get one little thing wrong in the code, the whole chain breaks down. And that’s how we look at things is like, if there’s a small breakdown in your fundamental mechanics, then the whole thing’s gonna be a problem. Then we gotta fix it from both angles. And I’m all about like, I just don’t wanna fix stuff. I wanna build it sequentially and give the students the best chance as they’re bringing the skills on board, so that we’re only moving forward and not trying to fix ’em from both ends or if we are fixing it from both ends because of a gap it’s easier to see because we’ve got so much of it put in place. And that’s why the scope and sequence is such an important part of this. We know exactly what we’re gonna cover scope and the sequence by which we’re gonna cover it, and again, I’m sure that was readily apparent. I mean, I don’t know how it feels on the other side, cause you can’t see all the ends to which we’re going in those first few days. I tell people it’s like “Karate Kid”, Mr. Miyagi style teaching DanielSon karate. DanielSon is like getting all mad cause Mr. Miyagi wants him to wax the car and sand the floor and paint the fence, but what he’s doing is he’s building the mechanics and then they all come together sort of on the back end of the training, and so I tell students this up front in one way or the other. I’m like, “Yeah, you’re not gonna see all the pieces at first, but it’s like, I’m asking for a three, to four day grace period. It’s like give us those three or four days, just drill down on it all, and then you’ll start to see how it comes together.” So grounded in the learning sciences, what else, so you had three criteria, right?

Yeah, so my second criteria is really looking for those evidence based learning approaches that I had mentioned earlier that you’re so familiar with. They have to be present in the method in some way, and like you said, it’s one thing to teach the theory behind that like, “Oh yeah, this is what spacing is.” Or, “This is what retrieval practice is,” but I think you and I both agree that it’s useless unless you teach your students how to use it appropriately using,

In context.

In context, yep, in context. And again, if I’m talking about, “This is how you use a memory palace to learn a grocery store list,” or, “This is how you make a visual map to learn the presidents of the United States of America.” That’s a joke, forget that. It’s gotta be like, “No, this is what it looks like when you’re learning about the causes of hyperthyroidism. This is what it looks like to learn the circle of Willis or okay, you gotta Dense Pharm lecture on pharmacy drug classifications” or what have you, So you’ve gotta play it out there. And what was the third one?

The third one was, is this systematic approach, it’s interconnected and has methodology that feeds on one another, which is really, really important. It’s not just standalone pieces of advice, but rather it’s a systems based approach, and that’s really important to me as well.

I mean, and I tell people this all the time, like people ask me for tips. I’m like, “Where do tips end? If you only need tips, then you probably don’t need our help, you know? If I were someone who needed help, if I’m in med school, if I’m in vet school and I’m struggling, I’m stuck on my boards, I’m a physician. I can’t pass my emergency med boards or whatever. I don’t want tips. Tips are gonna drive me crazy. I’m gonna get mad about, I should get mad about tips. I want wholesale end to end answers, and that’s why we have the STATMed study skills class. That is an end to end package. We have our board’s workshop. That’s an end to end package for what it covers, redesign the way you take tests, and we’ve got our newer one-on-one study skills course for people who are too busy to do the class, and we just wanna do our core study methods there, but it’s gotta have a scope. It’s gotta be systematic. It’s gotta be interconnected. It’s gotta be, and I would add it has to be flexible and modular. It can’t be a static construct. Now I think test taking can be fairly static cause we know exactly what the board’s constructs look like. But when we talk about study skills, I mean learning biochem is different than learning anatomy is different than learning other disciplines and one teacher might teach it differently than another teacher. So you’ve gotta have flexibility and modularity and interconnectivity with, they’re like Lego bricks that you can rearrange. So I think those are all a big part of how methodology matters, and then to me, methodology matters because we know that methodology matters in so many other walks of life from exercise to sports skills development, to if you wanna learn how to draw better. I mean, methodology matters, and yet in the field of medical education, in the health sciences, it’s almost like an elitist, like you made it to our school, so you’re smart enough, so get through it, and if you can’t and this might sound and you might disagree with this, but it’s like, if you made it here and you’re struggling, well, this is what students tell me, you made it here, you’re struggling, and you’re not doing as well as you should be, maybe it’s on you, maybe you’re not trying hard enough.

That’s ridiculous. Yeah, nothing more annoying.

That’s how the students feel.

Yeah, I know. Well, but that’s an authentic experience that they’re having. I’ve heard this before and I think I just recently did a faculty development module for another company that we work with on why do struggling students struggle? You know, what the basis behind that, right? And one of the things that I really tried to emphasize on that is that a lot of the default reasons that faculty or instructors or administrators or staff will go to when they’re dealing with a struggling student, is that, “Oh, you’re not motivated enough, or you just don’t wanna be here enough, or maybe you’re just not smart enough. You weren’t prepared enough by your undergraduate degree that you,” and while admittedly, in some cases, that might be part of the reason, but the reality is it’s student success and learning is just so much more complicated than that and I just get really irritated when people get reductionist in that way, because then they’re not really looking to solve the problem. They’re just looking for an excuse to get rid of a student.

It’s passing the buck. I mean, I’m sure if you look at a pie chart of students who are struggling, that is a part of the pie, but then you gotta get past that wedge of the pie.

Yeah, you do otherwise, right.

And what happens for so many students in the class is that they are accused of that. and I mean, what a gut punch.

You can see it and I think what a lot of people don’t understand is that, if you’re a student in one of these programs and you are constantly failing and you’re killing yourself, right? You get caught in this vicious cycle of, “I’m just gonna work harder, do more.”

That’s all you can do.

You get demoralized very quickly and easily, and that destroys your motivation, you know? And so people are talking about like, “Oh, this student’s lazy or they’re not motivated.” Well, maybe they’re not motivated, but the reason that they’ve lost their motivation is because they’re just so profoundly broken by their,

Constant negative feedback, and what I would say is some of my students I see is they will hold themselves over that flame for months, if not semesters, if not years. So they’re holding themselves over this traumatic flame, getting negative feedback. Maybe they’re just scraping by, maybe they’re getting by, but at terrible personal cost, and then the wear and the tear, and that’s what gets ’em, and then that one thing happens and they have a bad day. They get sick for a few days and their compensatory mechanism runs out. I mean, we say it’s not a problem until it’s a problem, but problem can be a lot of different things. It doesn’t always have to be failure. So, yeah, methodology matters though. So what we have to understand, and this is what I don’t think that every Dean across the land does understand, methodology does indeed matter. If you infuse highly intelligent students with an array of appropriate, flexible tools, along with their understanding of how learning works, it opens up so much, and again, there’s never a guarantee, but this is to me where I think you can really revolutionize a lot of this stuff instead of chasing the magic key, the skeleton key, to unlock curricular design. It should be more about, let’s really unlock these students’ abilities to learn. So yeah, methodology matters. That was your first one.

Thanks for tuning in to this episode of the STATMed podcast. If you like the show, please be sure to rate it on iTunes, Stitcher, Spotify, or wherever you listen to your podcasts. You can find more test taking and studying strategies, specifically designed for med students and physicians over at our blog at STATMedlearning.com. Thanks for listening.

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