Revamp Your Revision with the Leitner System

Revamp Your Revision with the Leitner System

Every healthcare student knows the feeling of being confronted with a waterfall of information that sometimes seems impossible to retain. The best tool to tackle the overwhelm are efficient and effective study strategies that suit your personal learning style and that you are able to consistently use. The Leitner system has gained popularity for its practicality and effectiveness. This post explains how it works and how you can apply it to your studies!

TABLE OF CONTENTS

Flashcards for studying with the Leitner System
Lecturio Team

  ·  

October 7, 2024

What is the Leitner system? 

The Leitner system is a learning strategy developed by Sebastian Leitner in the 1970s. It involves reviewing flashcards at increasing intervals to reinforce memory, and sorting them into boxes based on how well you already know the material.  

Who was Sebastian Leitner? 

Sebastian Leitner was a German science popularizer and commentator known for his book “How to learn to learn,” a practical manual on the psychology of learning, in which he presented the Leitner system.  

Main steps and principles

The Leitner system works as follows: 

  • You have a set of flashcards covering all aspects of the topic you are studying. 
  • Each card has a question or prompt on the front, and the answer/explanation on the back. 
  • You have a set of boxes representing different stages of mastery: At the beginning, all cards are in box 1, meaning you have not learned the item. 
  • You review the cards per box. The spacing of the frequency with which you review a box’ contents increases as the boxes progress, which is based on the assumption that more difficult cards need more frequent review.
  • You start by reviewing all cards in box 1:
    • Correct answer: Every card you answer correctly moves into box 2. Once you have reviewed it in box 2, it moves to box 3, and so on. 
    • Incorrect answer: Every card you answer incorrectly stays in box 1. If you answer a card incorrectly in box 2, 3 and so on, it moves back to box 1. Alternatively, you can decide to only move wrongly answered cards back to the previous box instead of all the way back to box 1. 
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Variant 1: Moving cards you got wrong back to box 1. (Source)
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Variant 2: Moving cards you got wrong back one box.  (Source)

How and why does the Leitner system work? 

The principles of spaced repetition and active recall

The Leitner system is based on the proven learning method of spaced repetition. Spaced repetition means to systematically increase the intervals between reviews of previously learned material, capitalizing on the psychological spacing effect. Each review session reactivates the neural connections associated with the memory, making them stronger and more durable over time. 

Additionally, the system employs active recall, forcing you to retrieve information without cues, which further strengthens memory.

Focusing your time and effort onto weak areas

By making you review topics more the more often you get them wrong, the Leitner system makes sure you focus your effort on areas that need more attention. At the same time, this keeps you from spending valuable time reviewing topics that you already remember well! 

Advantages and disadvantages of the Leitner method 

Pros

  • Efficiency: The Leitner system drastically reduces the time you spend reviewing information you already know. It makes you focus your time on areas you don’t remember well yet, taking away the effort of prioritizing and figuring out which area you should review.  
  • Proven effectiveness of active recall: Spaced repetition and active recall are proven-effective learning methods. The spaced review with flashcards is a 
  • Adaptability: Since you can set the review intervals however you like, the method can be adjusted based on your learning speed, material difficulty, or urgency. The only rule to follow is that the review intervals get longer with every box, with box 1 being reviewed the most often. 

Cons

  • Overemphasis on memorization: Like other study methods focusing on memorization, this does not cover all aspects of studying. For some topics, pure memorization may be enough, but for many complex topics a deep understanding of context and practical application to practice problems are essential parts of mastering the topic that are not covered by the Leitner system. Examples include mastering dosage calculation or epidemiological studies. 
  • Time investment in setup: Creating the flashcards and boxes can take up a significant amount of time that you may not always have. The effectiveness of your review heavily depends on the quality of your flashcards, so don’t rush it. In cases where you are too pressed for time, choosing a different method may be a better option than not paying the necessary attention to flashcard creation. Tip: There are tools out there that can save you time! For example, “dende” uses AI to create questions based on a PDF you upload. Notedexapp is a digital flashcard tool that even supports handwriting for anatomy drawings.
  • Physical space: Working with a large number of paper cards and boxes can take up a lot of space on your desk or shelves. If this bothers you, check out Leitner system apps that can help manage this digitally instead. 

How to use the Leitner system for your studies (step-by-step guide) 

General tips

  • Train yourself to think in question/prompt – answer pairs: Phrasing your information as questions and answers for the flashcards’ front and back sides can take a bit of practice, but it helps prepare you for exams better than simply narrating the contents. Pose the questions in a way that forces you to remember and understand all aspects of your answer. 
  • Integrate visuals: Especially for subjects like anatomy, diagrams or sketches on your flashcards can help make things more tangible. 
  • Customize your intervals: Depending on your exam schedules and the volume of material, adjust the intervals between box reviews to suit your learning pace.
  • Combine with other study methods: To offset the disadvantages of the method explained above, make sure to additionally use other study methods like practice questions from a Qbank, clinical simulations, and case studies. 

1. Preparation

  • Prepare the flashcards: Make sure to cover all key points you need to know about a topic. Phrasing them as questions and answers can take a bit of practice, but it helps prepare you for exams better than simply narrating the contents. Train yourself to think in question/prompt – answer pairs, posing the questions in a way that forces you to remember and understand all aspects of your answer. 
  • Set up the boxes: Decide on the number of boxes that makes sense for the scope and difficulty of the topic. Most people start with 3–5 boxes. 
  • Set the study intervals: For each box, decide on your study interval. Cards in box 1 are studied every day, box 2 might be every other day, box 3 might be once a week, and so on. Use a calendar or notes to schedule out your review process, so you always know when to review which box. 

2. Review 

Start with all cards in box 1. If you answer a card correctly, it moves to the next box. Depending on which variant of the Leitner system you use, incorrectly answered cards move back one box, or go back all the way to box 1. 

3. Cards in the final box

Cards in the last box that you answered correctly can be considered mastered. They should still be reviewed occasionally. For example, reviewing your mastered cards could be an easier study program for less focused days. 

Examples for flashcards and use cases

  • Pharmacology: Flashcard front: “What is the mechanism of action of Metformin?” Back: “Metformin decreases hepatic glucose production and intestinal absorption of glucose and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.” Another helpful way to use the system in pharmacology is for learning drug classes. 
  • Anatomy: Flashcard front: “What nerve innervates the deltoid muscle?” Back: “The axillary nerve.”
  • Pathophysiology: Flashcard front: “Describe the pathophysiological process of asthma.” Back: “Asthma is characterized by chronic airway inflammation, airway hyperresponsiveness, and reversible airflow obstruction.”
  • Clinical cases: Each flashcard front presents a tricky clinical case, with the diagnosis and treatment plan on the back. 
  • Medical terminology: A great way to use the Leitner system is to learn medical terms, as the system works especially well and simple for language-learning tasks and recalling the meaning of individual terms. 
  • Diagnostic criteria: Flashcard front: “Describe the diagnostic criteria of rheumatic fever.” Back: “Jones criteria: 2 major or 1 major and 1 minor manifestation.” → then listing the major and minor manifestations. 

Conclusion 

For healthcare students, mastering a significant amount of complex information efficiently is key to success. The Leitner system is an effective and practical tool to achieve this. It can be adapted for a range of different needs and situations. Give the Leitner System a try – it might just be the tool you need to optimize your learning and achieve your memorization goals. 

The best way to study is interactive

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