Study like a Pro    

Evidence Based learning 

The old adage goes that nothing in life is certain but death and taxes. As an anaesthetic trainee, we can add exams to that list. And as healthcare providers working long hours whilst balancing busy professional and personal lives, it can become a challenge to dedicate the appropriate time and effort that these exams require. The European Diploma in Anaesthesiology and Intensive Care (EDAIC) exam is an important and well recognised benchmark that many of us are working towards but can struggle to achieve. With two parts, a written multiple choice question (MCQ) exam in multiple true/false (T/F) model followed by an oral examination, it can be hard to prepare and the curriculum can seem vast. But with timely and strategic planning, you can achieve not only recollection of information but true mental model formation for important concepts that will serve you well throughout your career – after all, although it is a “tough” exam, the knowledge covered by the EDAIC is fundamental for safe and independent practice as a fully qualified anaesthetist. In this article, I will provide you with some evidence-based study methods and tips to help you make the most out of your preparation phase for upcoming exams.  

EDAIC Part I:  

Comprised of 60 MCQ in multiple T/F models and no negative marking, it is important that you answer ALL questions for your best chance of passing. Whilst the T/F format may seem simpler than open questions or single best answers, it often requires a deep understanding of the material, as each statement can be deceptively nuanced. Therefore, to succeed in this exam, it’s essential to use evidence-based study techniques that maximise retention, improve comprehension, and enhance your test-taking strategy.  

EDAIC Part II:  
The Part II exam consists of four 25-minute oral examinations, called SOEs, held in a single day, two in the morning and two in the afternoon. The two SOEs in the morning will concentrate on basic sciences and the afternoon SOEs will cover clinical sciences. It can be daunting to prepare for a “Viva” style exam, especially if you have not taken part in this form of examination before, but practice and adequate preparation are your friends.
In order to help you prepare for your exams, I have laid out below some research-backed strategies to help you excel in the EDAIC part I and part II examinations. 

1. Active Recall  
Active recall is a proven learning technique that involves testing yourself on the material, instead of passively rereading your notes or textbooks. This strategy enhances memory retention by forcing your brain to retrieve information, strengthening neural connections. [1,2]  
How to Implement Active Recall:

• After reviewing a chapter or topic, close the book and test yourself by writing down key facts or concepts you remember.
• Create flashcards with statements from your study material and test yourself by deciding whether the statements are true or false.
• Practice with a mix of simple and complex T/F statements, challenging yourself to recall the underlying concepts.

2. Spaced Repetition  
Spaced repetition leverages the spacing effect, which shows that you are more likely to retain information when you review it over increasing intervals of time. Instead of cramming, you revisit material regularly, which leads to better long-term retention. [3]  
How to Use Spaced Repetition:

• Break down your study material into smaller chunks and plan your review sessions over several days or weeks.
• Use flashcards or apps to help you focus on the material you find most challenging.
• For each T/F statement, regularly review the ones you got wrong to reinforce the correct information.

3. Interleaving
Interleaving refers to studying different topics or subjects during the same study session rather than focusing on one topic at a time. This technique enhances your ability to distinguish between concepts and strengthens your memory by forcing you to switch between different cognitive tasks. [4]
How to Implement Interleaving:

• Rotate between topics during each study session or use a mix of questions covering different topics to review previous learning at the end of each study session.

4. Eliminate Extremes and Focus on Nuances
Extreme statements with words like “always,” “never,” “only,” and “completely” are usually red flags for false statements, as very few things in medicine are absolute. On the other hand, more balanced statements require a higher level of attention to ensure nuances are fully understood and, therefore, mistakes are not made. So it is important to read each statement carefully and be mindful of absolutes presented.

5. Mind Mapping and Conceptual Connections
Mind mapping is a visual technique that allows you to connect various concepts, helping you understand relationships and dependencies between key topics. This method can be particularly effective for both T/F questions and oral examinations, which often test your understanding of the relationship between different ideas. [5]
How to Use Mind Mapping in your study:

• As you study, place central concepts in the middle of the page and branch out related ideas with important keywords highlighted, and, as much as possible, visual representations of topics should be used to allow better retention.
• Make connections between related topics that are often tested together. For example, when studying basic topics such as anatomy, make a note of related clinical correlations, such as regional techniques, important landmarks and complications of each block, as these will often be tested together.

6. Practice Under Exam Conditions

• Mock oral exams have proven to be invaluable in preparing for the actual examinations, especially when it comes to “Viva” style exams. By simulating real-world conditions, they allow students to refine their communication skills and receive constructive feedback, and research has shown that, when integrated into study routines, they can increase student confidence and performance during actual assessments. [6]

7. Take Care of Yourself
Your physical and mental well-being directly affects your cognitive function, so it’s essential to maintain a healthy routine while preparing for exams. Research consistently shows that sleep and exercise can improve memory, focus, and mental clarity as well as be associated with improved academic outcomes. [7,8]
How to Optimize Health for Exam Success:

• Aim for 7-9 hours of sleep each night to improve memory consolidation and cognitive function.
• Incorporate physical activity into your routine to reduce stress and improve focus. Regular exercise has been shown to improve memory and cognitive performance.

Conclusion
Preparing for an important and comprehensive exam such as the EDAIC can be daunting, but it is important to remember that it is achievable with the right preparation and you are already an anaesthetic trainee delivering anaesthesia in your daily clinical practice, so you know more than you think! Plan appropriately, prepare yourself by applying some of the strategies above in your study and look after yourself and you’ll be set for success in your EDAIC exam.

Good luck!

References

1. Roediger HL 3rd, Butler AC. (2011). The critical role of retrieval practice in long-term retention. Trends Cogn Sci. 15(1):20-7.
2. Dunlosky, J., et al. (2013). Improving Students’ Learning With Effective Learning Techniques: Promising Directions From Cognitive and Educational Psychology. Psychological Science in the Public Interest, 14(1), 4-58.
3. Cepeda NJ, et al. (2008). Spacing effects in learning: a temporal ridgeline of optimal retention. Psychological Science, 19(11):1095-102.
4. Rohrer, D., & Taylor, K. (2007). The shuffling of mathematics problems improves learning. Instructional Science, 35(6), 481-498.
5. Nesbit, J. C., & Adescope, M. O. (2006). Learning with concept maps: A review of research. Review of Educational Research, 76(3), 413-448.
6. Robinson P, et al (2017). Mock OSCEs Improve Medical Students’ Confidence and Reduce Anxiety Related to Summative Examinations. Education in Medicine Journal 9(2):41-45.
7. Okano K, et al. (2019). Sleep quality, duration, and consistency are associated with better academic performance in college students. NPJ Sci Learn. 1;4:16.
8. Lambourne K, Tomporowski P. (2010) The effect of exercise-induced arousal on cognitive task performance: a meta-regression analysis. Brain Res.23;1341:12-24.

Author

• Sofia Rosas, Anaesthetics Trainee, West of Scotland School of Anaesthesia, Glasgow, United Kingdom