34th Annual Scientific Meeting proceedings

Introduction
This lecture explores evidence-based learning practices to enhance knowledge acquisition, retention, and application. We will examine what defines surgical excellence, the vital role of memory, the efficacy of various study techniques, and the impact of external factors on focus, with an emphasis on board exam preparation.

1. What makes a good surgeon?
Surgical excellence transcends technical ability, encompassing attributes vital for both clinical practice and exam success:

• Fast thinking: Critical thinking, problem-solving, and rapid decision-making are essential for navigating complex cases and exam scenarios.
• A huge learning capacity: A deep understanding of pathophysiology, surgical principles, pharmacology, and constantly evolving data.
• Being adaptable and resilient: The ability to adjust to unexpected challenges and learn from setbacks applies equally to managing surgical complications and mastering exam technique.
• Communication skills: While seemingly indirect, understanding these principles is often assessed in scenario-based exam questions.
• Motor skills: Can these be learned?
• Metacognition: Awareness of one's own knowledge gaps, seeking feedback, and refining study strategies are hallmarks of elite surgeons and successful exam candidates.

2. How much are we expected to know? And is learning this much even possible?
The volume of knowledge required for veterinary exams, especially specialist certifications, is vast, demanding comprehensive understanding across multiple disciplines. It can feel overwhelming, but learning this much is possible with the right approach.

The expectation is not just rote memorisation, but the ability to integrate and apply knowledge. Our brains are highly capable when using efficient strategies. The key is to move from passive information consumption to active, deep processing. Learning is cumulative; connect new information to existing knowledge to build a robust, interconnected network. Strategic prioritisation of high-yield topics and consistent, distributed practice over time make the immense task manageable. It's a marathon, not a sprint, and effective study techniques are your training regimen.

3. What does the published literature tell us About effective learning techniques?
Cognitive science consistently points towards active engagement with material for exam success:

• Active recall (retrieval practice): Consistently ranked as a top technique. Instead of re-reading, actively retrieve information from memory (e.g. flashcards, self-quizzing, explaining concepts from memory). This strengthens memory traces and identifies knowledge gaps.
• Spaced repetition: Reviewing material at increasing intervals over time leads to better long-term retention. Use tools or self-manage to revisit content just as you're about to forget it, preventing cramming.
• Elaboration: Connect new information to existing knowledge, ask "why" questions, and explain concepts in your own words. This deepens understanding and prepares you for applied exam questions.
• Interleaving: Mix different problem types or topics within a study session rather than massing practice on one topic. This builds the ability to discriminate between problems and select appropriate strategies, a critical exam skill.
• Concrete examples: Anchor abstract concepts to specific clinical cases or surgical scenarios.
• Dual coding: Combine verbal and visual information (diagrams, images with text) for improved comprehension and retention, especially for anatomical and procedural topics.

4. Are highlighting and re-reading genuinely effective?
While popular, highlighting and re-reading are among the least effective study techniques when used in isolation for exam preparation:

• Highlighting and underlining: Provides minimal benefit. It encourages passive reading, creating an illusion of knowing without deep processing or improving actual recall.
• Re-reading: Increases familiarity but often doesn't translate to genuine understanding or the ability to retrieve information under exam pressure. It's inefficient for long-term learning.

These techniques are passive. They don't demand active retrieval or manipulation of information, which is crucial for strengthening memory and building robust knowledge structures needed for exam performance.

5. What are the effects of external disturbances on our focus?
External disturbances significantly impair learning and exam performance by fragmenting our finite attention:

• Cognitive load task-switching: Our brains task-switch rather than multitask. Each switch incurs a cognitive cost, reducing efficiency, increasing errors, and leading to shallower processing – detrimental to effective study.
• Distraction and divided attention: Notifications and background noise fragment attention, leading to reduced comprehension, longer study times, and poorer retention. Recovery from interruptions is time-consuming.
• Impact on deep work: Complex learning requires "deep work” - sustained, uninterrupted focus. Distractions prevent the brain from forming the robust neural connections essential for true mastery and efficient exam recall.
• Stress and fatigue: Chronic distraction leads to mental fatigue and stress, further impairing memory, attention, and decision-making.

To optimize learning, create an environment that minimises disturbances: turn off notifications, find quiet study spaces, and set boundaries.

Conclusion
Excellence in veterinary surgery and success in examinations are achievable through a commitment to evidence-based study practices. By embracing active recall, spaced repetition, elaboration, and by proactively minimising distractions, we can significantly enhance our learning efficiency and knowledge retention.