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The importance of active recall in learning anatomy

Contents

Introduction

“If you want to test your memory, try to recall what you were worrying about one year ago today” - E. Joseph Cossman

Memory is a wonderful and complex process which allows you to store information in a way that you can remember it later on. It is the way via which you recollect snippets of your childhood, various funny incidents from your past, what you ate for dinner, and the anatomy of the human body. It is essential for your personal development and making you unique compared to those around you. In essence, memories make you, you.

While everyone understands the significance of memory, very few understand how information gets inside the brain and becomes one. Not to mention that only a small minority really know how you remember information, nevermind how it can be done actively and efficiently. Since the latter is drowned in misconceptions and attacked by controversies, it doesn’t tickle the fancy of many teachers, professors, or students.

Hippocampus (memory centre) - cranial view

However, understanding the above processes is actually indispensable for long-term retention. Just as Crossman, “the Messiah of the free enterprise system”, placed test, recall, and memory in the same sentence, so too are they intricately connected inside your brain. The umbrella term for them is active recall and it is one of the most efficient strategies to help you manage that mound of information called anatomy. This article will discuss the meaning of active recall, the intricate processes hiding behind the name, crush the misconceptions, and explain its benefits. In other words, it will show you its true potential.

What is active recall?

Active recall is a principle of efficient learning. As the name suggests, it means remembering by straining or stimulating your mind. When used, it instantly switches on your brain and forces you to really use it. If you think reading is tiring, wait until you start applying this principle. It is actually an uncomfortable feeling for your brain. You almost feel it straining. Although immensely useful, it’s not easy, but “you can only grow if you are willing to feel awkward and uncomfortable when you try something new”.

How does active recall happen?

Active recall is so important and powerful in learning due to process of memory retrieval itself. While remembering, you re-access information from the past which has been previously encoded and stored in your mind. Essentially, the brain ‘replays’ a pattern of neural activity created in response to an event. It’s exactly like creating a movie - many scenes are shot, edited, stored, and then linked together into a final, coherent story which is played on your TV.

Movie

To assemble these reconstructions, different elements of the event stored in various parts of the brain are accessed and subsequently linked by neural networks. The strength of these pathways determines the speed of recall. Every time you try to remember something, you actually reinforce its connections. Therefore, the more you use active recall to revise, the easier you will remember the information.

In addition, this learning principle also recruits all the neurons involved in that specific memory. To access and create links, your brain retrieves a collection of candidate terms to which the familiarity decision is applied. It’s like some of your anatomy multiple-choice questions - you don’t really know the answer but you recognize the correct one.

Controversies and misconceptions

Once active recall started to be backed by science in 2009 (more details later), controversies ensued. Some experts believed the following:

  • Fostering rote memorization - This is one of the oldest and inefficient ways of learning. It was believed that students are taught some information, they read it, recall it, and spit it back out.
  • Learning through any kind of studying
  • One recall suffices - The belief that once you recall a piece of information once, you can stop revising it.
  • Repetitive studying improves retention
  • Meaning of active recall - The word ‘active’ is not necessarily referring to the use of physically active study methods like concept mapping, drawing or note taking. If used incorrectly, these can be utterly useless for learning.

All of these are actually false. Studies have shown that active recall is superior for long term-retention than encoding (inefficient studying). This holds true even when the test requires inferences or is in a completely different format compared to the original learning strategy. Retention is also improved by repeating via retrieval and not encoding. Actually, learning without active recall is completely useless for long-term storage of information. Therefore, stop simply transcribing information and start learning for real using active recall!

What classifies as an inefficient method? Anything that involves having a book, notes, or hints open. For instance, passive re-reading, re-taking notes, re-drawing concept maps, etc. The crucial aspect is the ‘re’, meaning the reading or familiarizing has been done before. This is essential initially, but after the first time, it is a complete waste of time. It’s like learning to drive a car by reading about driving or getting in the driver’s seat. You think they will both teach you how to drive, but in fact only getting behind the wheel will really teach you the skill.

Versatile

You might ask yourself - ‘what kind of knowledge is active recall good for?’. The good news is, a lot, especially the one involved in anatomy. If you want to memorise definitions or trajectories (you cannot escape verbatim memorization completely in this subject), active recall will help you. Do you instead need to memorize the branches of the maxillary artery (enumeration), or describe the blood flow pathway (sequence)? Active recall can help you more than staring and reading them. Even if you go one step further to understand the material deeper and make inferences, this method will be your best choice. Once again, these are scientifically proven!   

Enumerating

Prepares you for the unexpected

You are comfortably sitting down in your medical office and a patient walks in, or you are called to an emergency in room 452 on the 5th floor. You don’t really know what to expect until you get there. Fortunately, all your training prepares you for the unexpected and the heavy feeling in your stomach becomes negligible.

Using active recall to learn does something similar. When you use it you are testing yourself. You have no notes, no books, no cues. You are on your own two feet. Anatomy exams hit you without any hints and your patient will certainly not connect the dots for you. Don’t be afraid to learn using active recall even if your upcoming exam consists of multiple choice questions, or in a completely unrelated format. In fact, retrieval practice can improve long-term retention by 50% when tested with exams containing both verbatim and inference questions. After all, “there’s more than one way to skin a cat”.

Cements knowledge and saves time

The typical learning strategy of 99% of students: open a book, read, take notes, close the book, allow days to pass, revise by reading, repeat a few more times, wait for the exam, revise again by reading, and be optimistic that it sufficed. Do you see the problem? It is inefficiency and time wasting. Why is that? There’s no straining involved! The brain doesn’t have to generate an answer so it doesn’t break a single sweat. You are familiarising yourself rather than learning, even if you see the same facts four times. “Repetition is the mother of all learning” only goes so far if the repetition is poor and not fruitful.

Clock

Fortunately, active recall cements knowledge. The information remains engraved in your memory for a long time. For instance, a piece of correctly recalled information only needs to be revised after one day, then in three subsequent days, then in seven days after the last revision, then in another twelve days. You certainly get the picture - active recall equals time saved. On top of that, because you actually learned it the previous time, it’s not new but a refresher. It’s a joy to get through the material! Combine this with reviewing the material right before you start forgetting it by using a program like Anki and you can wave goodbye to time wasting.

Insightful

It’s evening time and you are still slouched over your anatomy book. You have studied this subject for half a day, your eyes are bloodshot and your brain cannot take it anymore. You look like Frodo at Mount Doom before destroying the ring and you don’t want to go through this day again. If you have used active recall, then you are in luck because this nightmare will not come back. The insightful nature of retrieval has arranged that.

In addition to its other benefits, active recall pinpoints your mistakes. By remembering the information solely from memory, you identify gaps in your knowledge, and you learn properly from the get-go. For example, you might remember the course of the musculocutaneous nerve arising from the brachial plexus, traveling through the axilla, and passing down the arm. However, you keep forgetting about piercing the coracobrachialis muscle and passing between the brachialis and biceps brachii muscles. This is a gap in your knowledge, which is easily picked up if you try to recall the course of the nerve without any cues or hints. Your mind just goes blank, so you can find out what’s missing when you check your answer. Embrace those mistakes because they offer the greatest potential for learning. A great basketball coach once said, “if you’re not making mistakes, then you’re not doing anything”. Be a do-er rather than a passive learner!

Mistakes

Where are the drawbacks of active recall? There are none actually because it is not a method per se, but a principle. It is actually the hottest one in town at the moment. Therefore, it can be used by many specific learning strategies.

Overall, active recall is a principle involving the difficult task of reconstructing memories. While it can be a slightly mentally uncomfortable task to practice, it is crucially important and has significant benefits. Don’t let its novelty deter you from improving your anatomy learning. It has helped a lot of students and it can certainly help you!

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Show references

References:    

  • McDaniel, M.A., D.C. Howard, and G.O. Einstein: The read-recite-review study strategy: effective and portable. Psychol Sci, 2009. 20(4): p. 516-22.
  • Karpicke, J.D. and J.R. Blunt: Retrieval practice produces more learning than elaborative studying with concept mapping. Science, 2011. 331(6018): p. 772-5.
  • Karpicke, J.D. and H.L. Roediger, 3rd: The critical importance of retrieval for learning. Science, 2008. 319(5865): p. 966-8
  • The Human Memory, accessed on 19/07/2015

Article, Review and Layout:

  • Adrian Rad
  • Franchesca Druggan

Illustrators:

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