I used to work really hard and all I got were pretty average results, then I got a wake-up call. I realised my mistakes. I made some changes. And I got to top 10 in Cambridge University. So, if you're cruising along on average thinking this is your limit, read this and start making the changes and see your limits break. 

Today, I want to talk about 2 mistakes that I was making that held me back and kept me average despite putting in hours of hard work. And 5 changes I made that helped me grow from average to top 10 in Cambridge with quite frankly far less work than I'd ever imagined. Then at the end I'll talk about my techniques for rapid memorisation that helped me memorise a lot of things in a very short space of time. I’m making this video for all those who have given up on themselves thinking they’ve hit their limit, it’s time to realise the problem isn't you and start making changes to break those limits.

Back in school for GCSE and for A-levels, I used to make notes. I looked at the textbooks, and basically copied out the text in bullet form cutting out the connecting words. I didn't really pay attention when making these notes. I'd just write it down and feel accomplished. Then I would read my notes, highlight them. And re-read them over and over again. And you know what, that worked fairly well at the time. Now you're thinking

But let me tell you, thinking that the key to learning was note-making was my first and biggest mistake.

I got to University and and I tried it, quite religiously during my first term. I'd spend hours at my desk just copying out the lecture handout in my own bullet format. Again not paying too much attention to what I'm writing. Even at that time, I understood that making notes actually didn't contribute to my learning or understanding. But for some reason, I wanted the notes to be in my bullet-format. And I justified it by thinking to myself

Thinking that I could commit to memory a term's worth of knowledge by reading just once, was my next mistake.

Anyway, come Christmas holidays, we get told that our first exam will be in January. At this point, I still hadn't finished making all of my notes. So I spent a few days even back home making notes, still not actually trying to pay attention to what I was reading. Then I eventually got to reading the notes. Honestly, it felt like it was the first time that I was ever reading these ideas. I did my best to read as much and as fast as possible, fully aware that I had a lot to cover in not a lot of time. I eventually, managed to read all the notes once. But read did not translate to remember. This became very apparent when I actually sat down to do the exams. And basically, eventhough I had worked hard all of term and during the whole holidays. I just managed to scrape a pass. I remember for the first few weeks after that thinking, "maybe I'm just not cut out for it". Like maybe this is my limit.

Then I had a turning point. One of our supervisors was also a student in his 4th year, he'd got a first every year, so I knew he was legit, and he told me this. "Shaene, why don't you stop making notes and just read the material". The suggestion in itself wasn't life-changing, it was quite basic in fact. But the idea that it was not me, it was the way that I was learning that was the issue, completely revolutionised my life. I was determined to make changes to see if that was actually true.

The changes I made were 2-fold. The first set of changes were to how I approached each lecture in terms of how I approached learning and understanding the material. The next set of changes were to how I went about memorising the material.

The first thing I changed was that I stopped copying out lecture notes or textbook information. Instead I started doing these 3 things for every lecture. Pre-read, Active presence and Post-read.

For each lecture, I'd allocate some time the day before to read the lecture handout provided by the university. I termed this my "first-pass"

This helped me in 2 main ways:

In terms of the big picture, reading the whole lecture in advance allowed me to get an an idea of of how the different subsections fit together and how the lecture fitted in with the overall topic. This process of trying to get the big picture I later found out is termed concept mapping and has been shown to be a powerful tool in teaching, but of course I didn't know it at the time. I just did it because I felt like it was helping me.

Now, in terms of realising what I didn't know. Whenever I encountered a concept, word or idea that didn't make sense to me, I'd train myself to google it straight away. I'd then get a good description from Wikipedia or somewhere that allowed me to understand it at the time and I'd put it in the handout right next to where the word or concept is mentioned. Having all the information in one place meant that I wasn't wasting time later re-searching things.

On occasion, there'd be times where Google wasn't enough and despite my initial search, I couldn't find an explanation that allowed me to reach the "understanding" level. When this happened, I'd put a star next to it. This would then alert me to pay closer attention during the lecture when the lecturer speaks about it, but also would prompt me to ask about this either after the lecture or in a supervision. I was actively seeking out and highlighting my areas of doubt, and then actively tried to solve it firstly independently then failing this, at the secondary level.

These 2 things, big picture concept mapping and identifying gaps in knowledge massively helped me learn new content and actually understand it.

I use the term active presence to mean that I trained myself to be switched on and ready to note down an important concept or a really good description or explanation. The important point here is that this is something I could achieve only because I had pre-read. It's not reasonable to expect ourselves to be maximally alert and conscious of everything being said for the whole lecture. But because I had pre-read and starred areas of doubts, I knew which moments to prioritise. And also because I had pre-read and mentally concept mapped, I was familiar with most of the material so that even if I zoned out, I could rejoin exactly at the current point in the lecture.

To practically enforce "active presence", I'd mentally note what points come before my point of doubt. This would act as my trigger to start zoning back in. I found that by pre-setting the trigger points, I was able to zone in right before the point I had to be maximally aware.

This system had a pretty good hit rate and this "active presence" mindset helped me out so much mentally. I went from being worried that I was going to miss something important, to knowing beforehand "these parts are going to be important", I need to be awake for this part. And because I had set my trigger points, I could sit through the lecture stress free, knowing that my trigger points will make sure I don't miss the important things.

So, all in all, "active presence" allowed me to cut myself a bit of slack whenever I did zone out and it also made me maximally aware during the moments the lecturer would speak about the concept I had doubts on.

This was the first pillar in my consolidation phase. With pre-reading and active presence, I had collected data, information and tried to reach a stage of adequate understanding. And it can be tempting to leave it at this. But I always made sure that post-lecture, I'd allocate time to consolidate the material I had learnt.

Now, this doesn't mean that I just re-read the handout again but with all the annotations now. Instead I practiced active retrieval of information and I'd do this in chunks. In psychology and evidence-driven learning, chunking and active recall are both powerful memory tools. I leveraged these techniques to make sure I not only consolidated and added to learning and understanding, but I also started my memorisation journey.

Practically, I'd do this by splitting the lecture I had to post-read into "chunks" or sections that was logical. Often lectures themselves would be split into sections by subheadings and often that system was logical enough for me. What I'd do is read the subheading and look away or cover the text below. The subheading would act as the trigger to retrieve information related to that chunk or section. I'd then close my eyes and try to recall all the key points within that section or chunk. Once I'd squeezed my brain as much as possible. I'd then read that section to make sure I hadn't missed anything. If I got a retrieval of say 90%, I'd be happy enough and move onto the next section. If it was less. I'd repeat the process. And I'd do this until I went above my 90% threshold. Then move on to the next section and so on. I termed this as my "second-pass".

This served to boost my learning and understanding, because it forced me to connect the dots within a section myself. I could only do this if truly understood the story within the section. Like if I was just rote learning, I'd need a trigger from one point to the next. But obviously I didn't allow myself to have this. So I trully believe this system, forced me build the connections in my head through understanding how one point connected to the next to form the whole story.

But not only did it boost understanding, this "second-pass" also started my memorisation journey.

Memorisation

Once I'd done my first pass pre-reading, active presence during the lecture and completed my second-pass post-reading. I'd then turn my attention to moving all this information into my longer-term memory. Now, one of the mistakes I made early on was not allowing myself enough time for this to happen. So, as I started making these new changes, I was determined to now allow myself more time. I forced myself to do a third-pass within the week, where I'd do the whole active-retrieval process. I'd allow at least a day between the second and third pass. I'd usually do the third-passes on the weekend when I had no new lectures and more time to review things. I termed this "the weekend review".

And this whole process "first pass pre-read, second-pass post read and third pass weekend review", was essentially spaced repetition which is a powerful evidence-driven tool to enhance our retention of information. Now, if I was doing this the proper way, I should have done a fourth, fifth pass at increasingly longer intervals. But, at the time I wasn't really aware of the science of it all and also who has the time, when there's just so much new content coming at such a rapid rate. So after the third-pass, the next time I usually encounter that lecture would be during my holiday revisions. Like I said, this wasn't ideal. But I just couldn't find the time during term to fit anymore passes and still learn new content. So, I prioritised learning new material and keeping current, which I still believe was the right move.

Now especially with medicine, there's plenty of things that don't really require any real understanding and just requires "memorisation". Just doing spaced-repetition without active-retrieval works fine for holding unconnected individual pieces of information. Like learning the number of muscles in the forearm.

But there were cases where we had to memorise linked items like for example in second year we had to learn viruses and their classification. Or in my clinical years I had to learn a load of conditions that could cause shortness of breath for example. To do this, I'd create stories. Now bear with me here. Let me explain how I created a story to remember the causes of acute SOB. I'd create a main character, in this case "asthmatic Andy", who was actually based on someone I knew called Andy and was asthmatic. Then asthmatic Andy would go through this crazy day where weird things would happen and new characters would be involved. But each weird thing to happen or each new character was associated with the condition I had to memorise. Like the thing to happen will be associated with the condition either through sound or idea. As an example of idea association, a bee sting is associated with an allergic reaction so I used the bee to remember anaphylaxis (severe allergic reaction). As an example of sound association, I'd use Flash the super-hero to remember flash pulmonary oedema or crew to remember croup. But basically, I found that I was able to remember these weird stories as they always progressed and I could pin on the conditions to be remembered using sound or idea association. This way of memorising things became quite fun and actually sped up the whole process massively. Like within 20 minutes I learnt all of the main causes of SOB.

Another way I remember things really quickly is by using mnemonics. Let's use chest pain as an example, there's a set of questions you have to ask a patient who comes in complaining of chest pain. And I remember them by using the mnemonic POPSAC. I remember this because I think of the heart as a sac that pops during chest pain. And each letter represents the question to be asked. Palpitations, orthopnea, PND, SOB, ankle swelling, chest pain. This I find is really powerful way of remembering things very quickly.

Now doing all of this can seem like it'll be a big drain on your time and happiness, but it really doesn't have to be and actually in the long-term it'll save you so much time and worry. If you want to know more about how to do more with your time and become happier as a result then definitely check out this video. Or if you want to learn about more evidence-based study method, my friend Ali has an amazing skillshare class which you can checkout for free using the link below.