Bradford VTS Online Resources:
I Failed My Exam
- How to Study: effective learning strategies (BVTS)
- Overcoming exam anxiety and nerves (BVTS)
- Five Ways To Make Peace With Failure
- So you failed a test, what now?
- How to recover from failure (good)
- How to Overcome Failure: 9 Powerful Habits
- How to stop underachieving in exams
- 29 signs that you’re going to fail your exams again! (I love this one)
- How to encourage someone who has failed an exam
- How to help someone who has failed an exam or test
If you have files you would like me to host on here and share with others, OR if you would like to help develop these pages further, then please email me.
How to bounce back from failure
Study less, study smart (v. good)
I feel crushed, I failed my exam... what should I do with myself?
I’m not used to failure… I was a straight A student in my senior year of high school… Got an A in all my A levels. I even did really good in all my medical school examinations. But I failed one of my GP training exams. I just didn’t expect the exam to be so difficult… It blew my mind… In high school, I could always cram and it would get me an A the next day I took the test. I feel like I’m the only one… I mean even though I did cram, I still studied and I did take notes in class. I’m disapointed in myself. I don’t mean to ramble on, but I feel ashamed of myself right now.
This page is perfectly designed for you. Please read this pages and all the resources on it. Take your time. Don’t read it all in one go. Revisit the material several times over the next 7 days. Don’t do anymore studying until you have done this. Let’s slow things down a little, breathe and get our bearings. The information on this page will show you how to get exam success at your next attempt – but to do so, you need to read it very carefully and slowly.
Dr Ramesh Mehay
Learning to live and accept what you've got
Yes, you have failed – but you’re not the first and loads and loads of doctors have failed before you; and many of them have later succeeded to become great doctors. Sometimes, it is the failure that actually makes you a better doctor. Failure can be a good thing if you are prepared to learn from it to better yourself. Let’s look at Einstein. Did you know that he was not speaking as well as other children at age 4. Did his parents give up on him? Did they think they were going to have a dumb child? And what about Walt Disney – the great person behind cartoons like Tom and Jerry. Did you know that he was fired for lacking imagination. I would like to think that his firing was also responsible for his success. Perhaps it made him think “I need to do things differently if that is the way I am percieved?”. Who knows!
And even when I look at my own journey it’s interesting. People think I am a higher flyer – because I’ve been a Training Programme DIrector for 16+ years, written a well established training book and for a number of other resources. But you ask anyone in my medical school year – I was generally in the lower quarter of my medical school class of 200 people. It’s true. And yes, I flunked 1st year, I flunked 3rd year and I failed my finals. (By the way, that’s why I went into teaching because I felt deeply and passionately about teaching people in a way that was easy, effective and fun rather than the traditional rigid way which I was exposed to and had to endure).
And yes, I believe my immense successes have their roots in my former failures. I am grateful for experiencing them. Yes, at the time – it did not feel good, but I can say now, years later, if it wasn’t for them, I would not had my moments of enlightenment. The funny thing is.. I’ve looked at the research, and it says there are many aamzing teachers there who have failed exams in their undergraduate years.
When I was a Training Programme Director, some of the most amazing doctors I have come across have been people who have not gone to medical school directly after school exams but have taken a more interesting convoluted route like doing a degree in agriculture first or working as a nurse, or doing a biomedical degree science first.
So yeah, you have failed. Yeah, you’re going to feel bad and feel low about yourself. And maybe you feel like you a rubbish doctor compared to others on the GP training scheme. But where do you go next? You decide? Like I said, lots of people (including me) have failed lots of things before you, and the failure is the very thing needed to a deep and meaningful success. Have a think. Make your choice now, what’s next?
But it feels so bad. I feel terrible inside.
Of course you’re going to feel like that. It’s a totally NATURAL and UNDERSTANDABLE feeling. So embrace it. Accept it. But be kind to yourself. If your inner dialogue is kind and calm, like “Oh dear, I failed and I feel a bit down”, then that’s okay. Stay there and let it be. And see if you can bring yourself up a little the next day or the day after. The important thing is to let it be. Whatever you do, DO NOT HIT THE BOOKS AGAIN SO SOON. Take a break. Go out with your family and friends and do a bit of shopping or a meal or take a city break. Be kind to yourself.
If you dialogue is more like “Damn, I failed that exam. I am so stupid. I’m never going to make it. What’s wrong with me. Why am I such a crap doctor”, then that dialogue is not so healthy. What would you say to someone you love who spoke to themselves that way? This sort of dialogue is cruel and unkind and will do nothing but get you unnecessarily down further. Try and change this dialogue to something more compassionate like “Actually, no, I am not stupid. I just need to find a different way because what I did clearly did not work for me. I feel down, but that’s okay and it’s normal”.
One thing that definately helps is talking to others.
I know you feel upset, angry and embarassed. You will have a number of mixed emotions and you probably won’t want to talk about any of it to anyone. But talking helps – and you know it does. After all, that’s why we encourage our patients to talk don’t we. We want to hear their lament because lamenting is therapeutic in itself. And in a similar way, you need to lament too. You you think about talking to several people to express yourself so you can move on. Perhaps…
- A close colleague like a fellow GP trainee
- Your partner
- Your Trainer
- One of the other GPs in the practice
- Your Training Programme Directors
A personal story... (read this)
I took my AKT test and I failed! The grade I got was worse than my first exam! What was I doing wrong? At this point, I began to surrender to the way that I simply wasn’t as savvy or clever as my kindred learners on the training scheme. In any case, it was unfair – I could go throughout the late evening studying and still come up short while my companions got high scores and never seemed to be revising much! But life’s not fair, right? Maybe I wasn’t as capable for acing my tests as were they. Perhaps I was simply predetermined never to arrive at similar levels of success that they could? Should I concentrate on being content with where I was and simply acknowledge that.
One night another trainee —somebody who passsed with really great scores — and I were hanging out and we talked about the exams. “They’re extreme, aren’t they?” I said. “No doubt! I truly needed to study hard for this one” she replied. Wait, what? I never saw her revising and getting stressed out! And here she was, revealing to me that she truly studied hard? What did she mean?
It turns out that she knew something I didn’t. What she knew going into the test was that she could study as hard as she could, but if she was not studying in a way that let her brain absorb the information effectively, then she might as well have not studied at all!
In contrast to her, I discovered that I had no study or learning plan and, as the saying goes, my failing to plan was planning to fail me. It was clear that I was studying haphazardly or aimlessly all the way up to the exam. In fact, I tried to cram a lot of last minute chapters the night before! Sadly, our minds don’t work that way do they. By remaining up throughout the night, I was simply wasting my time as opposed to really retaining the material.
What got me here wasn’t going to get me there; if I planned to carry on with the same study strategy as before. My study routine required a redesign.
I turned my performance around by figuring out how to study more efficiently – smarter, not harder. I made a study plan that made me focus on my weak areas. And when the exam came around, I quickly felt the difference. Never again was I frantically searching for questions that I knew the responses to. Rather, I responded to most questions effortlessly and with more certainty. And I could make good educated guesses on those things that I didn’t know. Later, I gomy results: I had nailed it.
The best trainees are not really talented, gifted or more fortunate than all of us. They basically realise how to study smarter as opposed to harder. Despite the fact that in my first and second attempts I had worked harder and routinely late throughout the nights compared to my colleague, her study methods permitted her to both master the knowledge more successfully and in less time.
Success in your exams is not reserved for those who are naturally gifted. Any learner can achieve it providing they use an efficient study strategy that is well paced and gives you a decent night’s rest before examination day. I know it is difficult to relinquish your old examination study techniques that may have served you well in the past – yet remember – your last test was a fall as a direct result of it and no doubt you felt you worked super hard and stressed. So, time to take a courageous move and get familiar with an alternate way – simpler, less pushed and will serve you for the rest of your life (and pass the AKT or CSA).
Right, I better hit the books again hadn't I
No, no and NO.
- Please don’t hit the books straight away.
- Take a break for at least 3 days first.
- Speak to others to vent how you feel.
- Don’t study until you feel you are back in the right frame of mind. You need to be at the point where you feel ready to start learning again. You also need to feel positively determined to pass at the next attempt and believe that it is do-able.
- And don’t go into denial. It’s the worst thing you can do – to blame the exam for being unfair or the college for testing “stupid” stuff. If you take the POSITIVE steps outlined below, there is a very significant chance you can be successful.
I blew the exam! Now what?
Remember, FAIL means Failed Attempt In Learning.
How do I develop an effective and efficient new study plan?
Trust me, these things work. But you have to do them rather than read and nod to them.
- Do you think your study plan helped you? If you worked hard and failed, it is possible you were working harder, not smarter. Perhaps you focused on the wrong things. In any case, you need to re-examine your previous study plan and either change it significantly or create a new one.
- To create or amend a study plan in order to make it smarter, you need to first understand Metacognition. Metacognition is “thinking about learning”. Equip yourself with what the RESEARCH EVIDENCE says about what are the best ways to learn rather than relying on what you’ve always been taught or what you think sounds logically okay.
- Go to the Bradford VTS page: How to Study: effective learning strategies (BVTS)
- Watch all the video clips on that page from Professor Chew.
- Yes, it’s painful, but you got to do it to diagnose where you went wrong. You can only fix things once you have a working diagnosis.
- What went wrong on the exam? Be honest with yourself.
- Did you focus on the right things?
- Did you do the enough preparation?
- Did you do poorly on lots of things? In which case, it sounds like your study regime was not good.
- Did you do poorly on just a few areas? In which case, you need to map out those areas and then develop a study plan that focus on them.
- Did you cram things in at the last minute? Last minute cramming means you did not do enough preparation and that you had a poor study strategy.
- Do you think you misinterpreted questions or didn’t follow instructions? If so, discuss with your trainer or TPD. Perhaps you need to learn techniques to calm yourself down and not get flustered. Perhaps you need to read things with a bit more care.
- And if it is because of exam anxiety, stress or nerves, read this page for techniques to help settle you: BVTS pages on Exam Anxiety, Stress & Nerves.
Develop a new learning strategy. Don’t just go with the old. Put yourself in the best possible position for passing the exam. Set realistic goals. Don’t jam pack your learning plan with too much stuff – why set yourself up for failure; you’ll start feeling you’re never on top of things, and that’s not a good motivating feeling for learning. You study habits should have built in periods to relax, recharge through periods of rest, good sleep, and doing some of the nourishing activities in your life (like socialising, going for a run, cooking, time with family etc).
- PART ONE: Map out your weak areas of knowledge
- Now work out how you will tackle them.
- What resources will you use – books vs online vs test.
- PART TWO: What deep learning techniques will you use?
- Get actively involved in your learning (as opposed to rote memorisation). Understand concepts – once you truly understand them, you will never forget.
- Let go of poor study skills
- Like just reading a book from cover to cover and highlighting.
- Re-reading the same written material again and again (rote learning) is also inefficient.
- Highlighting doesn’t work. Why? Well, consider this question: “When do you highlight stuff?”. Answer – usually on the first read – in other words, when you are totally unfamiliar with the content. So you end up highlighting everything, not key concepts. And actually, when you re-read a highlighted chapter again, you think “oh yeah, i remember that” and falsely think highlighting is helping you to remember stuff. But actually this is misleading – you have NOT remembered that, you have merely recognised it because of the very fact that you have come across it before. Recognising is not remembering – I bet you could not paraphrase it in your own words. But highlighting gives you the false illusion that you have remembered something and therefore you don’t try to remember any of it because you think it’s in your brain just because you have recognised it. That’s why highlighting is SO ineffective and highly misleading. Break the habit. Stop doing it. Instead, get actively involved in your learning – make summaries, mind-maps, flash cards or simply try to recall things and test yourself.
- Is what you’re learning a fact or a concept?
- For example, learning the name of a muscle is a fact. Learning how it works is a concept. Learning concepts will stay with you a lifetime whereas facts just tend to just come and go.
- Put concepts in your own words – otherwise they will not be meaningful to you. It’s tempting to copy what someone else has written especially if it is worded superbly. And yes it is harder to put something “perfectly written” into your own words and seems wasteful. BUT if you go the extra mile by discover the meaning of a concept, and then summarise it using your own words, it embeds itself into your deep long-term memory. Make flow charts. Tables. Diagrams.
- For facts, you got to make them more meaningful if you are want to recall them at any stage. One way to do that is to use mnemonics.
- Acronyms: ROYGBIV – colours of the rainbow. OOOT TAF VG VAH – cranial nerves. Get confused between Afferent and Efferent? Use SAME – sensory are Afferent, motor are Efferent. Or Afferent Arrive towards the CNS, Efferent Exit away from the CNS. Using mnemonics will help you remember facts life long.
- Coined Sayings: Oh Oh Oh, To Touch And Feel Very Good Velvet, Ah Heaven for the Cranial Nerves. Righty tighty, lefty loosey (for which way to turn to tighten or loose something). Camels Often Sit Down Carefully, Perhaps Their Joints Creak. Perhaps Early Oiling Might Prevent Permanent Harm (Geological Periods).
- Interacting Images: the best of all! Make images out of facts to help remember them – the weirder the better. An obvious one. Carbs have 4 calories per gram. CAR has 4 wheels = CARbs have 4 cals per gram. Fats have 9 calories per gram. Think FAT cats have 9 lives! Alcohol has 7 calories per gram. 7 letters in the word alcohol.
- Read up on things in a contextual way.
- So, you might have it in your diary to read up all about UTIs in children tommorrow afternoon. But to make it pass effortlessly into your deeper long term memory, it would be better to learn it the next time you see a child with a UTI.
- When reading up on clinical material, try and change the context and see what you would do differently. For example, in adults, let’s say you are reading about UTIs. Change the context: what do you do if the urine dipstix is positive for leucocytes but not nitrites or protein or blood? Get my drift?
- Reading a clinical book of medicine methodically cover to cover will result in inefficient superficial short-term memory learning. But how about this: see patients – look at their Presenting Complaint (PC) AND their Past Medical History (PMH). For the PC – deal with it there and then with the patient. Look at their PMH and see what they have there that you’re not so confident about – and make a list to read it up later – perhaps at lunchtime, tea break or at home.
- If you are worried about looking as if you an incompetent unknowledgeable doctor in front of the patient – don’t be! Patients love it when we “double check” things in front of them. In fact, they’re often more impressed because other doctors they see usually don’t! They interpret it as being extra thorough and they love it. Instead of saying “I’m unsure about that, let me read up about it on Google” (which is a daft thing to say), think about framing your words more positively like “Mmmm…. let me just have a quick look at what the latest medical advice is for that” and share with them what you find on the PC. (Tip – try not to use Google to do medical searches; patients will think you’re not a doctor. Instead, go straight to well known knowledge websites like GP Notebook and NICE CKS). Let’s say a young girl is broough in by her mother for a UTI, you might say “Mmmm, well I’ve tested her urine and it looks like she has a water infection. Now, because she has had these before, she may need further tests to make sure everything is okay. Would you mind giving me a moment to look at what the latest guidance is?”
- Comparing and Contrasting is good
- It makes you think about the differences. That thinking results in processing into the deeper long-term memory part of your brain.
- For example, with the girl who has a UTI example above, how about asking yourself “How is the follow up management of a UTI diagnosis in boys different from girls?. If you know the answer – great. If you think you know but not 90% or more sure, look it up again – there and then! Remember what we said earlier – for knowledge to be embedded into long-term memory, you have to come across it at least 3 times in 3 different contexts.
- Preview previous learning before moving onto the next.
- When you read about something – try and test yourself on it afterwards or the next day.
- On day 1 of new material – why not read the new knowledge and summarise key learning points via use of flash cards. Then, the next day, before going onto new material, review the flash cards and test yourself!
- Be careful with fash cards though – if you write complete answers on the back, you’ll develop the quick superficial bad habit of turning the card around to read it if you don’t know. Consider leaving the answer off – just the question. Or perhaps just a link to the answer. This forces you to look it up if you don’t know. The act of looking it up will hardwire the information better.
- And rather than just skimming through what you “learnt yesterday”, actively test yourself – there’s so many ways you can do this. For example, in the UTI example – you could ask yourself to “make a quick management flowchart for UTIs in boys and girls”.
- Remember: cgnitive psychologists say you need to revisit material at least 3 times in 3 different contexts if you truly want to embed it into your long-term memory.
- These deep learning methods might seem slower than the quicker read-and-highlight method. But trust me, this slower method means information passes to your long-term memory thus aiding easy recall at exams. It is the slowness of the method that results in faster recall. It is based on research. The evidence comes from the field of Cognitive Pyschology (i.e. the study of how we learn). It’s difficult to let go of inefficient methods that we have been taught and have used for so long – but take a moment to think for yourself. Do you want to carry on doing something that has little proven value or something the research say definately does?
- Let go of poor study skills
- PART THREE: Create a loose timetable of when you will do what
- Choose a good time to study
- When are you most effective? You know when you are most alert. Are you a morning person, an afternoon person or an evening person?
- Map out other “natural periods” throughout each day of the week where you can learn. For example, after the surgery, at coffee time, at lunch time. Rather than driving home in rush hour traffic, stay at the surgery for 30 minutes and do some learning. The more you break up the learning, the more likely it will reside in your long-term memory.
- Space out your learning.
- Ensure there are restful/nourishing moments in your timetable for EVERY day. One of your weekend days should also be devoted to family, social or other nourishing time. You might think you are missing a big opportunity for learning if you don’t cut down on what you percieve as “temporarily unnecessary”. But the research says MORE learning is likely to be deeply embedded if there are periods of rest.
- And that goes for sleep too. Try not to study late into the early hours of the morning. Instead, ensure you get a minimum of 7-8 hours sleep. It is during REM sleep that the learning you have processed gets deeply embedded. Usually, REM sleep happens 90 minutes after you fall asleep. The first period of REM typically lasts 10 minutes. Each of your later REM stages gets longer, and the final one may last up to an hour. So, someone who sleeps 8h gets 4 sessions where they can consolidate their learning. Someone who sleeps 6h gets 3! Someone who sleeps 4h gets 2 sessions. You will be surprised at how much your learning performance goes up with good sleep. You don’t have enough time? Really? Think again.
- Chunk your studying and learning. Study for 25 minutes. Then break for 10 minutes. Then come back for 25 minutes. Repeat the cycle. 25 minute chunks are easily memorisable – anything longer is not.
- Make the learning process positive and pleasurable.
- You can make it pleasurable by doing things you really love in the 10 minute breaks.
- Rather than doing 3 hours of 25 minute learning chunks in the evening – how about looking for six 25 minute periods throughout your working day? It’s less exhausting that way and it makes learning far more pleasurable. Avoid doing 3h of learning at a time – even if you are taking 10 min breaks between 25 minute learning chunks – because that will just tire you out, make you feel glad when it is over and generally make the experience feel negative. And the next day, you tell me: are you MORE likely or LESS likely to be motivated into doing a thing that you have negative feelings towards?
- If you do engage in 2-3 hours of learning (but with 10 minute breaks at 25 minute intervals), reserve the last half hour for something really special and pleasurable. Psychologically, it makes you feel you are loving your learning process (i.e creates a positive attitude) as opposed to feeling exhausted and tired. What sorts of special things? You decide, it’s personal: perhaps a warm lovely bath, watch comedy, ice-cream, go out for a tea/coffee /cake or play a computer game.
- Choose a good time to study
The bottom line is that good study habits are EFFORTFUL because that means you are processing information deeply, meaningfully and permanently. Do you now see that methods like skim reading notes and highlighting books are effortLESS and therefore don’t result in effective learning which is easier to recall when you need it the most?
- Do you have a quiet place to study at home?
- If not, then make a quiet place to study in your home. Make it a no-go zone for others.
- Try not to choose the bedroom as it will always make you sleepy.
- Try not to choose the dining table as it will encourage you to make snacks and distract you.
- Avoid the living room unless you know you have the place to yourself.
- Perhaps the conservatory.
- Turn distractions off when it is time to study.
- That includes the phone. Even the little phone notification blips are enough to derail you from learning – that’s what the research says. It takes ages to get back into “learning mode” when a “ping” has gone off on your phone.
- Turn off the TV.
- Get your other half to see to the kids.
- If you like listening to music whilst learning – then choose music that is familiar to you but has no lyrics. Otherwise, you will subconciously sing to the lyrics rather than learn. And NO ONE can multitask. (PS Multi-tasking is a myth).
- Psychologically prepare your mind for learning mode.
- You can do this in a variety of ways.
- First of all, choose a chair that makes you sit upright rather than a laid back chair which encourages you to fall asleep. Use the same chair each time. You will build a mental association with that chair and studying.
- Another neat little trick is to buy a study lamp for the area at home where you will study. Turn the lamp on when it is study time. Turn it off when you are not (including the 10 minute breaks between the 25 minute learning chunks). Again, this builds a mental association between the lamp and studying. The turning on of the lamp will automatically push the brain into learning mode within seconds.
- Sit down with your TPD or GP Trainer.
- Tell them how you feel.
- Tell them why you think you failed.
- Show them your knowledge deficiencies.
- Show them your new learning strategies.
- Show them your learning plan.
- And finally ask them for their thoughts – they may have some exceptional ideas too. They are qualified educators after all.
- The research shows that if you are in a study group for something, you have a greater chance of passing an exam for it. Perfomance of the group goes up dramatically.
- This is partly due to the motivation boost that comes from study groups. But the other reason for success is due to the power of studying with other people.
- Individuals in a study group understand the way you think about a concept better than a teacher can and therefore can help you see a concept from a new light better that a teacher who is too far removed from you.
- In GP training, you will know that many trainees form CSA study groups. But if you’re doing the AKT, why not form a study group for that?
- Medical students – are you in a study group? Why not? Physician Associates – are you part of a study group? Why not? Nurse Practitioners – same question….. Why not?
- And teach others what you know. It helps consolidate the knowledge for yourself and helps educate others. Everyone is a winner. If you haven’t got anyone to teach, teach yourself in front of a mirror. Or teach your other half, even if they’re not into medicine! Research says 80% of your study time should be spent reciting and only 20% on reading!
- In the class, make notes. But not detailed notes. Just notes of the main framework. If you make detailed notes, you will not be able to keep up with the lecturer and you will miss out on things and not truly understand key concepts. So, make notes – but brief notes.
- Right after a class, expand on your notes – flesh it out. That will help you revisit the new learning a second time. But it needs to be done right after class. Doing it the next day is too late. Rather than drive home in crazy traffic, why not stay behind and write up your notes.
- Make flash cards to test you the next day or day after. Or teach others what you know. It helps consolidate the knowledge for yourself and helps educate others. Everyone is a winner. If you haven’t got anyone to teach, teach yourself in front of a mirror. Or teach your other half, even if they’re not into medicine! Research says 80% of your study time should be spent reciting and only 20% on reading!
- Most people don’t know how to learn from a textbook. Yes, they can read one, but they don’t know the optimal way to learn from one.
- Basically read it. Think about it. Recite it in your own mind – explain it to yourself.
- All you need to remember is SQ3R.
- S is for Survey – quick scan of chapter – title, subheadings, pictures and bolded text.
- Q is for Question – raise questions as you survey. What’s this picture about. Interesting table – what’s it about? How is the chapter laid out? Survey & Questioning should take 3-5 minutes per chapter.
- R is for Read – now read the chapter.
- R is for Recite – after reading it, see if you can recite parts
- R is for Review – review the material some time later – to see if you still know it and especially before the exams!
A few specific points on AKT/CSA fails
Especially for AKT fails: If you have failed a number of times, it might be because you have unrecognised Dyslexia. A lot of doctors have dyslexia and don’t realise it. It is common. Being dyslexic does not mean you have lower intelligence or anything like that. It just simply means that you learn in a different way to other people You simply have a different “thinking colour” than other people. Many wonderful achievers of our time have been Dyslexics – Albert Einsein, Richard Branson, Tom Cruise and Steven Spielberg – just to name a few. So embrace it and, in the first instance, talk to your TPDs about it.
One of the best ways to improve your clinical knowledge for both AKT and CSA is to continue seeing patients in surgeries. Do NOT take time off to sit down and read books. Do surgeries, see plenty of patients, and note what sorts of clinical things come up. Jot them down. During and after surgery, test yourself about how much you know about them. And if you’re struggling, then look them up THERE AND THEN. Remember, both the AKT and CSA exam are largely based on the what commonly comes through the surgery doors! And get your Trainer to start doing something called Random Cases Analyses (RCAs) with you. RCAs get you into thinking and testing mode, and that leads to deep and meaningful learning that gets embedded within your long-term memory than the superficial learning from books and notes.
Research shows reading books and highlighting things DOES NOT WORK. We all love doing it but it is pretty ineffective. The stuff you learn only goes into the short term working memory but what you want it to do is to go through to the long term memory so it can be recalled effortlessly. The best way to do this is to see patients, identify bits you’re weak at and strengthen them by learning in a CONTEXTUAL way with the patient whilst they are still with you. Then you won’t forget!
Some of these techniques I am suggested might seem slower and more labour intensive than the quicker reading of books and lecture notes. But you have to put trust in the research which says the slower and deeper learning methods are more effective because you hang onto the information longer and deeper. It is time to be brave and courageous and change what you are comfortable doing towards doing something that the research says is more impressive.