Academic programs in the health professions tend to place greater time demands on students, because the schedule includes long clinical practice sessions in addition to the usual lectures, seminar and laboratory sessions common to other college and university programs. The fact that many of these clinical practice sessions are away from the home institution further adds to time constraints.

These time demands require a major reorientation by students whose previous academic experiences have been in very different university or college settings. The transition is difficult for some who find that study skills that had served them well in college are no longer adequate. More deliberate attention must be paid to priorities, and tighter schedules require more careful planning if even the most important tasks are to be accomplished. Happily, the caliber of most students in the health professions is such that these necessary adjustments can be made quickly once a few basic planning tips are pointed out.

The guidelines here grew out of academic counseling sessions over a three-year period with students in medicine, nursing, and the allied health sciences. Often, students came after reading about the service in the student handbook or hearing it described in student orientation sessions. Most sought counseling because they believed their poor test results were due to weak test-taking skills or test anxiety. Although these factors frequently played a part, poor study skills and inefficient time management practices more likely were the basic causes of poor performance.

Although these guidelines were developed for health professions students, they can serve other students in higher education who need to adjust their modus operandi to meet the new challenges of their academic careers. The guidelines can be used by academic counselors as they work with individuals or groups of students. The following handouts may be used to reinforce major points and for future reference.

Handout No. 1

TIME MANAGEMENT SKILLS: GUIDELINES FOR STUDENTS

There are those who believe the true professional is the person who always has time to do everything there is to be done. There are others who believe that never running short of time indicates a failure to function at full capacity. Truth lies somewhere between these two points of view. Learning how to manage time in order to carry out responsibilities and reach desired goals in the limited time available is an important part of becoming a professional. Effective time management promotes feelings of accomplishment and success and contributes to overall emotional stability and peace of mind.

The remaining paragraphs suggest specific techniques for managing your time better as you wend your way down the path toward a career as a health professional. Obviously, the demands of your program, your course schedule, and your specific needs will affect how you apply these techniques.

Perhaps the most basic concept in time management is commitment, or the resolve to manage time more effectively. Such commitment stems from dissatisfaction with what has been happening—or not happening—and the feelings of frustration, helplessness, inadequacy, fear, and self-doubt which accompany this dissatisfaction. It quickly becomes apparent that effective time management does not just happen; it requires planning. Planning implies scheduling. Scheduling suggests routine. Time management can be seen as the process of deciding, ahead of time, what will be done and when. Decisions about what will be done necessitate the listing of tasks, preferably in the context of larger objectives or goals. Just when these tasks are to be completed is a separate, albeit related, issue. Knowing specifically and clearly what is to be done makes it easier to determine when it will (can, should) be done.

As the preceding suggests, it is not enough to generate a list of tasks to be accomplished. Determining when the tasks will be completed is essential and requires that you assign priorities. All tasks are not equally important or due at the same time. In order to decide upon priorities, you need to consider factors such as the task’s external deadlines, the time and effort needed to do the task, its sequential relationship to other tasks, your interest and motivation, and the availability of necessary resources (to name just a few). It is neither efficient nor effective to perform tasks in some chance order such as “first come, first served”. That kind of priority may work in the butcher shop, but it seldom will work for you when you are dealing with several tasks in one time segment, all of which are affected by qualitative variables.

It is important to be realistic in planning. It is very possible, perhaps likely, that on some occasions you simply will not be able to complete all of the tasks listed. You will find such times less stressful if what you leave unfinished has relatively lower priority than what you completed and if your schedule is flexible enough to permit the unfinished task to be reassigned to another time. Such adjustments are likely, especially as you are attempting to gain experience in estimating how long it really takes to perform certain tasks. Initially, you may have trouble estimating how long a task will take if you have not consciously kept track of the relationship of time to specific tasks before. As more effective time management skills develop, the accuracy of your time estimates will improve.

The type of planning referred to in this discussion is the antithesis of the concept of “crisis management,” especially as this occurs in the health care industry. Sometimes, in a health care setting, events and time must be managed with a crisis orientation or approach. The emergency room or the intensive care unit are obvious examples. Health professionals are likely to encounter such situations in their practice. Students in clinical or practicum courses may also face or, at least, observe them. However, too often the health professionals extend such spontaneous responses to non-crisis situations. For your own well-being, you should resist the temptation to convert your responsibilities as a student to an endless series of “crises”. Too often, these are fabricated to cover a lack of planning.

In practical terms, how can you improve your time managment skills? Begin by developing a detailed weekly schedule which includes school (e.g., classes, labs, clinical assignments) and non-school (e.g., weekly appointments, part-time jobs) time commitments. Collectively, these represent a major part of your weekly routine. Enter this information on a weekly calendar form—a two-way chart with the seven days of the week across the top and hours of the day (in one-hour modules) down the left side. Then, indicate time for personal morning preparations, meals and, if applicable, travel time to the Medical Center. The remaining time should be listed on a separate sheet of paper by the day of the week, with total time and specific hours associated with each day. Then decide which tasks are to be accomplished during those hours. Your choices should be based on the priorities you establish.

It is perhaps most manageable simply to associate a particular course or courses with these “free” (free for you to decide) hours. Keep in mind that you are planning a standard, essentially generic, schedule. Consider identifying some time just before and after each class to prepare and do immediate follow-up activities such as relating lecture notes to other sources or looking up difficult concepts or unknown terms. If possible, try to schedule “catch-up” time each week for the tasks not finished as originally scheduled. If you do not need the time for that purpose, you may choose to get a head start on the following week’s work, or you may use it for some social activity.

You should provide time for social activities in the schedule. If your classmates are involved in such activities, perhaps you all can agree on a common time each week and plan your individual schedules accordingly.

Once you have made these time-related decisions, it remains for you to generate specific tasks for each course. Some of these will be as generic as textbook reading and lecture note reviewing. Others may be specific to a given week, such as preparing a report or studying for a quiz. These task lists define the specific activities you will be engaged in when the scheduled time for a specific course occurs.

In the final analysis, effective time management means developing a plan which makes the best use of the limited time available while also reflecting individual priorities. It is being responsible. It is being professional. Greater success surely will result.

Handout No. 2

TEST-TAKING SKILLS: GUIDELINES FOR STUDENTS

A. Getting Ready

1. Learn the material. Obviously, nothing better prepares you for taking a test than learning the material that will be tested. Some basic suggestions about how to do that are offered on the next page.

2. Create a review plan and follow it. Leaving review activity until two days before the test is unwise. While, ideally, review activities are an ongoing part of the learning process, it is useful to create a specific review plan for each test. The essential elements of such a plan include a prioritized list of tasks and a schedule which not only identifies time slots for review work but associates specific tasks/activities with each session.

It is useful to set aside a block of time, perhaps two or three hours, each week for review work. It is advisable to supplement this by additional review sessions as the test date approaches. Added review sessions are most valuable if scheduled at least a week before the test. Starting sooner is advisable if the volume of material to be reviewed is extensive, if other tests are scheduled at about the same time, or if other assignments or commitments come due at that time.

If a reasonable review plan has been established and conscientiously followed, the temptation to cram will be reduced. While cramming may have helped in other educational settings, it is less likely to work in health professions schools. The accelerated pace of the academic programs, the amount of material to be learned quickly, the heavy schedule of classes, laboratories and clinical assignments, and the pressure to make rapid social and psychological adjustments to the medical center environment will all make cramming ineffective.

3. Review with other students. By explaining ideas, describing procedures, asking and answering questions, and discussing material with others, you can strengthen your learning. Periodic review sessions with one or more students can be helpful if all approach their commitments responsibly. For such sessions to be effective in meeting everyone’s needs, there must be a clear agenda of topics for each session and each participant must conscientiously prepare for selected topics by attempting to learn the material and preparing discussion questions. Drill on basic facts also may be included in these sessions. Participants are advised to alternate asking and answering questions.

B. Organizing Content for Review

1. Make lists. Perhaps the simplest way to start organizing content for review is to develop lists of things to be learned. Examples include lists of key terms, major concepts or ideas, and main messages. At this stage, there is no need to be detailed. These lists should be relatively brief but must encompass the content to be learned.

2. Produce information sets. Using these lists, produce a series of “information sets” that will promote learning and facilitate future retrieval. The most effective sets are relatively simple with little detail. They contain key elements of a concept, elements which when recalled trigger the detail necessary to flesh out the concept. These information sets, when collected in a series, should cover all of the main messages to be learned, but without all of the detail; these are inferred and are retrieved through associations with the elements in the information set. It is useful to create information sets which represent the material graphically. Flow charts which represent sequence and direction, anatomical drawings or sketches, charts, tables, and diagrams showing interrelationships are examples of graphic representations of content. These information sets may be modified, added to, or divided as you increase your understanding or acquire new knowledge. Your most important task is to learn the main messages and concepts first, the details later. This helps you avoid not being able to see the forest because of the trees. Using these information sets for review better assures learning and retrieving content in manageable and logical units or chunks.

C. Building Confidence During a Test

1. Determine what you control and what you don’t. Once this is accomplished, focus on the former. For example, devise strategies for answering difficult questions, rather than expending energy thinking about how the questions should be edited.

2. Plan alternative relaxation techniques to use during a test. Make a list which includes such items as slowing the pace of breathing, changing position to reduce tension and relax muscles, sipping a cool drink, resting eyes, shaking out writing hand, etc.

3. Provide positive self-reinforcement. Do not dwell on how much there is left to do but on how much you have already accomplished. First answer questions that are easy for you, skipping more difficult questions to return to later.

4. Let the percentages work for you. For example, on five-option multiple choice questions, every option you can eliminate increases your probability of getting the correct answer by 20%, even if you just guess in the end. For many questions, it is possible to reduce plausible alternatives so that the probability of being correct is 1 in 4, 1 in 3, or even 1 in 2. Over several questions on an exam, these probabilities improve· chances for correct answers and have a positive impact on the total test score.