Memory and Learning 

An important part of learning when studying for Fellowship exams is memory retrieval. When you are studying, you are attempting to transfer information from your short-term memory into your long-term memory. Retrieval is the cognitive act of retrieving or recalling this information from your long-term memory into your short-term memory. When you study information for the purposes of taking an exam, you are trying to learn it in a way that you are able to retrieve it later. But there are different types of retrieval that will influence how easily you will be able to retrieve information (in the form of memories) when you need it during your exam.  

There are three main types of Memory retrieval: 

  • Recognition – A feeling of familiarity for previously-encountered information. 
  • Free Recall – Retrieval of specific information from memory without cues. 
  • Cued Recall – Retrieval of specific information from memory based on an associated cue or information. This associated memory activates an associated node that’s related to the node of the information you’re trying to remember. For more information, see Stacie Sanchez’ blog about associative learning and knowledge structures. 

In other words, it’s easier to recognise something as familiar than recall details about it. Recognition takes less cognitive effort than memory recall. 

Understanding how your memory works 

Memory recall is influenced by three factors: 

  • Practice: how many times a memory has been used in the past 
  • Recency: how recently a memory has been used 
  • Context: the situation in the person’s focus (area of attention) 

As the saying goes, practice makes perfect. The more you practice a piece of information, the more likely you will remember it as memory activation depends on the amount of practice that it has received. That’s partly why your experience in a particular area of general practice is easier to recall than areas that you have less experience in; it has simply received a lot more practice. But practice is not the only thing that influences memory activation and recall. Recency, or how recently you’ve used or recalled a particular piece of information, also determines how well you remember that information. In other words, something that you’ve used very recently will be much more easily remembered (due to a higher activation rate) than a piece of information that has not been used for some time (low activation rate). As well as practice and recency, the third factor that affects activation is context. To understand context, it’s important to understand how memories connect through associations. For example, when you think about the word ‘inflammation’, you may recall associated concepts such as heat, oedema, redness and joint pain or stiffness. 

All these words are strongly associated with the word ‘inflammation’, and, when ‘inflammation’ is the focus of attention (that is, you’ve just heard it or read it), it spreads activation to other memories associated with it. The most active ‘chunk’ in your memory is the one selected as your first response; the next most active chunk will be your second response, and so on. Associations between concepts are highly personal and depend on previous experiences. For example, if you worked in a Sports medicine clinic, you may recall different words associated with the word ‘inflammation’ (such as sprains and strains) than if you worked in a general clinic with a higher ratio of elderly patients. In this case you may associate words such as arthritis, gout or rheumatoid arthritis. Associations are the links between the present (the current context we are in) and our previous experience and/or knowledge. 

But how does context affect the retrieval of information from memory? The present moment and environment (e.g., what you see, hear, smell, taste or feel) can be strongly associated with a chunk in our memory, thus spreading activation to other memory chunks, making it become more active. Have you ever noticed a smell (baking) evoking a strong memory (of your mother or grandmother’s famous cake)? Seemingly long buried memories can be ‘cued’ by our senses because of the cue in the current context (passing by a bakery) that spreads activation to it (the past memory of cake). 

Recognition vs. Recall 

The difference between recognition and recall is the number of cues that help memory retrieval; recall involves fewer cues than recognition, and therefore takes more effort. For example, answering a question such as ‘was Scott Morrison the Australian Prime Minister prior to Anthony Albanese? requires recognition: you simply have to recognise whether the information provided is correct or not. If, instead, you were asked ‘Who was the previous Prime Minister of Australia, you would use the process of recall to retrieve the right answer from your memory. Recognition is easier than recall because more cues spread activation to related information in memory, raising the answer’s activation for you to select it.  

Fellowship exams 

Common exam questions include multiple choice, extended matching or short answer response, such as in the ACRRM MCQ or the RACGP AKT and KFP. Multiple choice questions require recognition to answer, as you are trying to use new information (the question) to determine which associated memory you previously encountered (the answer). Extended matching questions tend to involve cued recall; you need to retrieve specific information from memory with some associated cue to (hopefully) activate that memory. Finally, short answer responses tend to be free recall, as you are trying to retrieve specific information from memory without associated cues provided in a prompt.  

Keep these distinctions in mind when studying for exams. If you know an exam will involve lots of multiple choice, work on strengthening the transfer of the needed information from your short-term memory into your long-term memory. If you know the exam will involve extended matching or short answer questions, spend your time working on strengthening the associations between them. 

Memory techniques: 

What are the most effective memory techniques that will enhance recognition and recall for exams, I hear you ask? There are three strategies you can use while studying to simultaneously enhance your recall and recognition.  

  1. When studying for an exam, try to engage in active elaborative rehearsal rather than maintenance rehearsal. Elaborative rehearsal is learning information within a context, with associations and linkages. You greatly increase the likelihood of successfully storing information in your long-term memory when you deeply process the new information along with its meaning, context and associations with other previously acquired knowledge. 
  1. Use maintenance rehearsal to remember facts and/or schedules. Maintenance rehearsal is a relatively quick process to store information in your short-term memory by repeating the information over and over again. Though this technique means that the memory will decay over time, it is a useful technique when you need to remember facts for an exam, such as immunisation schedules. The reason this style of rehearsal is less effective is because you are repeating information without context, meaning, or linkages to other concepts.  
  1. Another effective memory technique is active recall. This technique will enhance cued and free recall. Active recall involves testing oneself by actively retrieving information, such as with flashcards or answering questions (practice testing).  

Connecting what you are learning (new information) to something you already understand or link to a context that you are familiar with (e.g., patients or areas you work in) will enable easier retrieval of information when you need it. This strategy helps reinforce the new knowledge and situate it within a broader mental map that’s already been created (e.g., your past clinical experience).  

Though elaborative rehearsal is the better of the two types of memory rehearsal (as it allows for deep learning that will stay with you longer), maintenance rehearsal does have a place in exam preparation. For more information on these memory techniques, see Dominique Foster’s blog post.  

Study Tips: 

  1. Use mnemonics to help build associations between concepts, making them easier to remember. Mnemonics can be words or phrases. When you create or use mnemonics, you are creating an associative link in your knowledge structure between the word/phrase and a series of information, making it easier to activate the memory to bring concepts you have associated with the mnemonic to the forefront. For more information, see Stacie Sanchez’ blog about associative learning and knowledge structures. 
  1. Flash cards are a useful study technique for maintenance rehearsal. 
  1. Use practice testing to promote memory retention, ideally practicing under exam conditions. This promotes both cued and free recall, as well as elaborative rehearsal. 
  1. Study harder topics in novel places like the beach or a park. This association with a place will help with retrieval (e.g., remember the beach or park setting to remember what you were studying). 
  1. Studying with a study partner or group can enhance memory retrieval by its association with the context of the conversations had, particularly when teaching others or debating the pros/cons of a process. 

For more study tips, see those by Latrobe University.  

Exam tips 

While most of your ability to succeed in exams will be due to the amount of time you spend studying, there are a few exam tips you can try to enhance your memory.  

  1. If you feel like you’re about to remember something but can’t remember it exactly, try thinking “around” the question or topic by thinking of different things that might be related to what you are trying to remember. Because of the way mental models work, you might be able to activate memory nodes which are connected to the answer you are ultimately trying to remember, leading you to remember the answer itself.  
  1. Try using mnemonic devices that you created while studying. The use of a mnemonic device might provide you with enough of a cue necessary to recall the answer you are trying to remember.  
  1. Try to remember the context of what you studied if you are having difficulty remembering topic associations. For example, conversations had with patients, colleagues or supervisors, or where you were at the time of studying or reading an article (e.g., the room or area where you were) are all contextual associations that can prompt memory recall.  

Remember! Recognition of a concept doesn’t mean you’ll be able to recall adequate details about it in the exam when required. How easily information can be retrieved from memory depends on how often you encountered that information, how recently you used it, and how much it is related to your current context, such as your work. Richer contexts (like cues, links and associations) make memory retrieval easier. Ensuring you link and associate new concepts or information to well-known, familiar contexts will make the new information easier to recall. 

For a sneak peek at practice testing, try our Dr MCQ or Dr KFP FREE trial today.  

References

Budiu, Raluca. (2024). Memory Recognition and Recall in User Interfaces. Nielsen Norman Group. Accessed on 17/7/24 from: https://www.nngroup.com/articles/recognition-and-recall/#:~:text=Recognition%20refers%20to%20our%20ability,of%20related%20details%20from%20memory.  

Foster, Dominique. (2020). Elaborative and Maintenance Rehearsal. Accessed from on 19/6/24: https://techpsych.wordpress.ncsu.edu/2020/04/15/elaborative-and-maintenance-rehearsal/  

Interaction Design Foundation. Recognition vs Recall  https://www.interaction-design.org/literature/topics/recognition-vs-recall#:~:text=Recognition%20and%20recall%20are%20two,recognition%20is%20less%20cognitive%20effort 

Latrobe University. Strategies for exam preparation. Accessed on 19/6/24 from:  https://www.latrobe.edu.au/students/study-resources/learning/achieve/exam-prep  

Noble, Sean M. (2020) Recognition and Recall. Accessed from on 19/6/24: https://techpsych.wordpress.ncsu.edu/2020/03/18/hello-world/  

Sanchez, Stacie. (2020). Associative Learning and Knowledge Structures. Accessed from on 19/6/24: https://techpsych.wordpress.ncsu.edu/2020/04/15/associative-learning-and-knowledge-structures/