The Altius Story: Building An Evidence-Based MCAT Program
Memory and learning research has been an interest of mine for several years. I first became interested in this subject when taking courses in Educational Psychology during undergrad. The principles I learned then, and in my studies since, have dramatically changed my life. My love for learning and—perhaps more importantly—the speed with which I actually learn, have increased many fold as a result. In creating the Altius MCAT course I have attempted to create a system that maximizes the use of those learning methods that have been shown by science to be the most effective.
The Science of Memory
The process by which the human brain stores, condenses and retrieves information is still only partially understood. Researchers have established with some certainty, however, that the key processes occur at neuronal synapses. As we learn, these synapses undergo physiological changes that account for memory storage and retrieval. These processes include changes in the way neurons interconnect with one another as well as changes in the actual cell membranes themselves at the synapse.
Although the details of this process are still poorly understood, the science of memory on a macroscopic scale is among the most well investigated topics in modern science. Peer-reviewed studies demonstrating how humans learn most efficiently (or inefficiently) began appearing regularly in the literature as early as the turn of the century. Since then, investigations into memory and learning have continued in earnest. We now know with relative certainty which approaches to learning are most effective, those that are moderately effective, and those that are abysmally ineffective. Heading up that last category, or should we say “bottoming it out,” is the ubiquitous “lecture.” How in the world then, one might ask, is it that every major institution of higher learning in this country still seems to base their entire educational experience on lectures? That is a perplexing question indeed. However, more important for you, as future MCAT examinees, is to ask yourselves how this science is or is not being applied to your learning processes in preparing for the MCAT. With all due respect, Kaplan, Ace, Princeton Review, and everyone else I am aware of who offers live courses, appear to have entirely disregarded the science and blindly trudged forward with lecture-only formats.
Short-Term vs. Long-Term Memory
There is a pervasive misunderstanding of what constitutes “short-term” vs. “long-term” memory. The brain’s short-term memory storage system can hold information for only a few seconds to a couple of minutes. This is what would allow you to glance at a few words written on a chalk-board, quickly turn-away, and be able to recall what you saw. Long-term memory storage, on the other hand, accounts for everything you learn and remember for more than a few minutes. Even “cramming” for a test, therefore, utilizes long-term memory storage. The difference between this kind of memory and memories that you retain for years, is simply the “strength” of the memory. Several factors—which we will discuss below—determine the strength of the memory and therefore the length of time the memory is available for recall.
Spaced Repetition
Based on what I’ve described thus far, whenever you learn some new piece of MCAT information you will be placing that information in long-term memory. Whether or not it will still be there on test day will depend on the “strength” of that memory. The first (and by far the most important) way to increase the strength of your MCAT memories is via repetition. After your first attempt to learn something, each time you review the information again, or attempt to recall it from your long-term memory, your brain interprets this as a clue regarding the information’s importance. It is quite accurate to think that your brain gives this information a higher place in the “pecking order,” protecting it from housecleaning removal for a longer period of time. Don’t be fooled, however, it is still on a timer to be removed, the timer has just been lengthened. As time passes, if you continue to review it regularly, your brain will be convinced to expend the neuronal energy necessary to keep this information not only available, but “cached” at the forefront of your memory system for easier retrieval.
Interestingly, however, your brain is an excellent economist. It will not spend more energy than is absolutely necessary. Because of this, you can review the information too much, especially at first. If you review something, say 10 times during the first hour you learn it, your brain appears to actually de-prioritize that memory. It is as if the brain thinks, “this information is presented so frequently, there really is no need to remember it.” You will experience what seems to be a strong memory of such items at first, but this will be followed by speedy deterioration.
To avoid this, repetition should be regular, but with sufficient time intervals between recitations. It is generally accepted that you should review items at the first exposure the minimum number of times necessary to achieve good understanding and recall. Then leave it alone for one to twenty four hours. When you come back to it the second time, attempt to recall it only once, then leave it alone for 3-7 days. After that, come back to the information weekly, reviewing as needed for good recall. You can gradually expand the spacing to two weeks or more after several successful recalls, but NEVER put it entirely away. Several researchers (Crowder et al, 1976; Green 1989; others) have demonstrated the increased efficiency of this method over other approaches and have referred to it as the “spacing effect.” The 3-7 days of distance between review sessions seems to be the ideal amount of time for convincing the brain to give information the highest “strength” rating possible. Of course, if you miss that pivotal first or second review, or fail to complete your weekly reviews afterwards, you will lose the benefit of the spacing effect.
If you don’t remember anything else from these Weekly Strategy Sessions, remember the spacing effect. You MUST set up regular review of your note cards to make all of the efforts you’ve put in pay off as they should. I recommend having all of your cards on a schedule to be reviewed once each week, gradually moving them to two or three week intervals once you know them well.
Active Recall
Many people like to study by reading thru their notes, re-reading books, reviewing lecture slides, etc. These individuals will tell you it “works for them,” but it laughs in the face of hard science. The main problem being that the questions and answers are presented to the brain together. Your brain will NOT give a memory a strong strength rating if it is never actually forced to recall it on its own. Can you blame it? Think about it; would you invest any effort studying for the MCAT if questions were always presented WITH their respective answers? The term “active recall” refers to any situation where the question and answer are separated and the brain is forced to actively “look up” the information. This is accomplished quite well by note cards. The two absolute requirements are: 1) the answers MUST be obscured, and 2) your brain MUST attempt to retrieve the answer. This means you cannot just read the front of the card and flip it over. You must attempt to answer each card to the best of your ability BEFORE checking your answer. Whatever you do in your studying, do NOT just read thru question-answer sets together! Make note cards containing stems/prompts and force your brain to do active recall.
Simplifying and Chunking
Try to memorize this number: 50246775635023683392. Don’t read on until you have attempted it at least a couple of times. Now try it again using the principles of “simplifying” and “chunking.” These numbers are actually two phone numbers smashed together: (502) 467-7563 and (502) 368-3392. Without actually memorizing these phone numbers, can you sense that it would be much easier to do so now that they are “chunked” into simplified sets? Whenever you study for the MCAT, you should attempt to simplify and chunk. This is yet another scientific basis for the use of note cards. The process of making your own note cards should involve reviewing the lesson material and consolidating it into greatly simplified, “chunked” details. Your brain gives higher priority to chunked material because it perceives it as being able to be retained with relatively little effort. If information is too complex and unorganized, your brain will resist your efforts to retain it.
Expensive Information
One type of memory to which the brain usually assigns extremely high strength ratings, is information that was “expensive” to obtain. By “expensive” we mean information which you had to invest significant and/or repeated effort to capture. Don’t confuse this with repetition. This refers not to the number of attempts to memorize the information, but to the amount of energy and effort used to get the information into your brain for the first time. Suppose that you are studying and find a missing piece of information. You spend a half-hour on the internet researching the answer. This piece of information will receive a very high strength rating. By contrast, suppose you are reading the “Big Bad Kaplan Book” and read a fact directly off the page. This memory will receive an extremely small strength rating. This is one of the key reasons we include “fill-in-the-blanks” and unanswered questions in the lesson outlines. In fact, in subsequent editions we are likely to insert more blanks for information that can be easily looked up in a minute or two on-line. We know that if students spend a minute or two FINDING the information on-line, they will already be many steps closer to good long-term retention than they would be if they spent five minutes reading it over and over again on the page.
Rote vs. Semantic Memory
The entire Altius mantra of “learn it conceptually” instead of “memorizing it rotely” boils down to this proven scientific principle of learning. Rote memory is a term used to refer to information that is memorized without being fully understood first. It is mind-blowing how pervasive this type of learning is on college campuses (and in med schools too!). In physics, every pre-med student memorizes the equations for falling bodies, but I don’t think 1 in 100 truly understands the concepts and relationships these equations illustrate. Professors exacerbate this problem because they lecture and test in a manner that allows this type of learning to continue. Truth be known, there are a lot of professors who don’t really understand the “why and how” behind what they’re teaching.
If you can put this behind you and begin demanding a conceptual understanding of all your educators, you’ll be well on your way to marvelous accomplishments—including a killer score on the MCAT. This is more than mantra, however; there is scientific evidence for my soap box. The brain treats rote information almost as flippantly as the giant number I asked you to memorize above. Your brain knows that it will require enormous energy to retain long-term. It also knows from experience that almost every time in the past when you have tried to cram this kind of information into it, you’ve rarely ever used it again. Such information is assigned very low strength ratings and it therefore becomes very difficult to retain.
By contrast, memories that are based upon understanding—especially broad, conceptual understanding—receive very high strength ratings. These memories have been labeled “Semantic Memory” by scientists. “Semantic,” in Greek, translates “meaning.” In other words, semantic memories are those accompanied by meaning. Your brain finds this information relatively easy to retain because it can create multiple relevant neuronal connections with pre-existing memories. The memory comes with “context,” a spider-web-like attachment that allows neuronal interlacing. Not only is conceptual understanding many times easier to apply to MCAT questions, it is EASIER to remember and retain in the first place!
Episodic Memory (Visual, Olfactory, Emotional)
Just as meaning increases the strength of a memory, so do several other key attributes of the memory. In increasing order of strength, these are visual cues, olfactory cues, and emotional cues. These cues are all examples of “episodic memory,” a memory tied to an experience rather than an abstract attempt at rote memorization. Memories that are tied to visual cues, such as pictures, flash cards, symbols, etc. are automatically given higher strength ratings than those associated with text only. Those memories associated with smells tend to be very, very strong. Finally, those memories associated with emotional states such as excitement, stress, embarrassment, anger, etc. receive the highest relative strength ratings.
Except for a few “scratch-n-sniff” note cards I tried to make once, the olfactory cue has been the one principle we’ve been unable to effectively integrate into the Altius program. Visual cues, however, are integral to the advantage of using note cards over other study methods. Especially when note card information is properly “chunked,” the brain will associate the visual record of each note card with the information it is presenting. I have used note cards religiously for several years and have taken advantage of this “photographic picture” of the note card many times on exams.
As effective as visual and olfactory cues are, research indicates that emotional cues are even more powerful. Some of our strongest, longest-lived memories are those first learned during heightened emotional states. Ironically, if MCAT studying makes you cry, that may be a good thing =). It is known that one of the most effective emotional cues for learning is appropriate stress. Some degree of public anxiety, such as having to produce an answer in front of an audience, has been shown to dramatically increase the strength of learning associated with such an experience. Researchers Tony and Helga Noice published a paper in 2006 demonstrating how this principle helps account for the above average ability of professional actors and actresses to accurately memorize the thousands of lines of text found in a movie script. This observation indicates that the design of the Altius classroom sessions is highly advantageous. The opportunity to lead the group in reasoning thru a real AAMC question gives you a moderate level of pressure and stress that is likely to help you remember that particular principle extremely well.
Bringing it all together: The Altius Dual-Focus MCAT Program
The principles of learning and memory we have just reviewed are powerful tools you can use to succeed—not only at the MCAT, but in the many educational endeavors that lay ahead of you. They are the basis for the design and construction of the various aspects of the Altius MCAT program. For these reasons, we believe that no other MCAT program anywhere can give you a better chance at achieving a top score—the proven science is simply behind us. The conceptual focus of our program taps into the principle of “semantic memory.” The outline form of the lessons taps into the “expensive information” principle. The chronology of a pre-tutoring session review, followed by a tutoring session, post-tutoring session review, group session review and regular note card review, build appropriate “spaced repetition” directly into the program. The classroom sessions utilize multiple principles of memory, including “expensive information,” “semantic memory,” “active recall,” and “emotional episodic memory.” In summary, the things we ask of you are not just heart-burn inspirations I dreamed up on some sleepless night—they are evidence-based and will almost certainly improve your results to the extent that you adhere to them.
Best wishes,
Lauren