NEJM Knowledge+ Harnesses Best Learning Practices

In recent years, advances in cognitive science have brought new understanding of how the human brain acquires and retains information. So, just as the questions in NEJM Knowledge+ Internal Medicine Board Review are based on the best evidence in medicine, our learning solution is grounded in the best of neuroscience and psychology. We applied several core principles of educational psychology to the design and development of NEJM Knowledge+. These include: making learning active, facilitating self-direction, maximizing the benefits of the testing effect, using repetition and reinforcement to enhance memory, and increasing learners’ self-awareness via tools that enhance metacognition.

Here’s how to put the best of cognitive science and technology to work for you.

Learn by Solving Problems

Active engagement creates more robust learning and retention and has become a widespread goal of educators from grade school to graduate school. Case-based problem solving is particularly germane to clinicians, and it triggers more active mental engagement than reading text. Placing information in context, such as a clinical case, has been shown to build stronger neural connections than memorization of facts. Building on prior knowledge by adding new information onto familiar content similarly seems to activate learning.

Take Control of Your Own Learning

Highly effective learners are proactive. Effective educational programs provide opportunities for learners to exert control of their own experience. Today, that means that the most effective programs allow learners to engage conveniently for short or longer periods of learning, in flexible circumstances (such as between patient visits or while waiting in line).

Continuously Test Yourself and Absorb the Feedback

Recalling information from memory has been shown to actually improve memory and is better than studying without testing. Even answering questions incorrectly is more effective than passive reading, especially if incorrect answers are followed by feedback. One theory is that testing prompts us to forge more connections and therefore create a more enduring network for knowledge. Another view is that answering questions trains the brain to retrieve the information when asked. Whether you call it “retrieval practice,” “test-enhanced learning,” or “the testing effect,” evidence shows that answering questions strengthens your knowledge.

Spread Out Your Learning Over Time

Known as “spaced repetition,” “spaced learning,” or “the spacing effect,” this basic principle is now widely embraced: Learning that is spread out and repeated over time is more effective than fewer, longer learning sessions. Repetition allows for reinforcement and consolidation of existing memory. Spaced repetition also is superior to memorization, which tends to be fleeting. Spaced Repetition is regarded as the most time-efficient way to learn and study.

Vary Your Approach to the Material

Combining different types of learning approaches can enhance your ability to retain information. Using different types of questions and different recall methods can be useful. Even varying the place where you study can help.

Understand Your Strengths and the Way You Learn

Metacognition is an understanding of what you know and self-awareness of where you need to improve. It is essential for self-directed learning and a key to lifelong learning. Some psychologists have theorized that great athletes differ from merely very good ones based on an ability to identify their own weaknesses and to focus efforts on improving those areas. Such active self-awareness, or metacognition, is a key to learning. In the context of board review preparation, it directs your studying. Be honest with yourself about where you are strong and especially about areas in which you need more reinforcement.

By harnessing key principles of cognitive science with advanced computer technology, NEJM Knowledge+ offers a learning tool of unparalleled efficiency. For board preparation and ongoing practice enhancement, we have put these principles of cognitive science to work for you:

PRINCIPLE FROM COGNITIVE SCIENCEVALUE FOR BOARD REVIEW AND LIFELONG LEARNINGFEATURE OF NEJM KNOWLEDGE+
Active learningLearning in context aids retentionCase-based questions
Active learningYou can dig deeper for more contextVetted citations
Self-directionEnhance retention & proactive learningYou can resume where you left off
Self-direction & spaced repetitionProactive learners are the most effectiveMobile platform lets you study on your schedule
Spaced repetitionEnhance retention & proactive learningDifferent types of questions for a single learning point
Spaced repetitionMore opportunities to learn and reinforce topics that are difficult for you.Adapts based on your answer correctness, time spent, and confidence
MetacognitionEnhance self-awareness of strengths and weaknessesPerformance metrics via My Reports