Students have to memorize and understand ever-growing amounts of information and concepts in medical school. To conquer that, universities often urge their students to take the latest courses on “Learning How to Learn”, however, they themselves teach the way they have always taught. Students are responding with an all-time low attendance rate and seek outside help to pass their exams, which can lead to bulimic learning and a next generation of so-so doctors. Read below the first part of our interview series with recognized author Peter Brown to learn more about how we at Lecturio use “Make It Stick” concepts to improve student performance and long term retention, but also how you as a teacher can leverage those sticky ideas for your classroom.


Peter Horneffer: There’s a lot of interest in game learning and other forms of interactivity. Might interactive styles of learning perhaps fulfill some of the requirements of effort for learning while making the process feel less difficult?

Peter Brown: Well, sure, interaction is a great tool. One thing about interaction is that it can help you go back and revisit something that you just learned.

Then on earlier strength on that, it can give you corrective feedback when you make mistakes. You can draw deeper into the material and ask you to elaborate further on it and explain how it connects to what you already know or where this thing is located in the body.

“Interactivity is a very powerful tool.”

I can meet you where you are and it can help you construct the learning, the understanding going forward. The notion of games and interactivity I find highly intriguing because we all know from our own experiences when we’re doing something recreational that’s challenging. And it takes various effort, false starts, mistakes, turns, to get where you want to go. You see those false starts and those turns as learning not as “I’m not getting it”.

You say “I’m going to do it this way the next time” and you gradually build that competency—might be a video game, might be a sport. We understand that learning in that context, we just don’t have to bring that intellectually into mastery of things like medical education and other fields. We’re in mathematics and so, when it’s all there and I don’t see why that structure wouldn’t work just as well for making it more rewarding.

Peter Horneffer: One of our interests at Lecturio is using computer technology to help create this interactivity in ways that you couldn’t do in a traditional program. As I mentioned traditional programs and then traditional teaching methods. What do you see as the less effective approaches that have been used for years: is there still a place for an hour-long lecture?

Peter Brown: Well, not really. I think it is a pretty bold statement. Sure, maybe in a flipped classroom you listen to the lecture on your own time and you come into class and then you have structured in class a variety of ways in which you’re asked to retrieve the content of the lecture and demonstrate that you understand it or create the understanding through various exercises.

But we’re talking about learning, we’re not talking about teaching. So, the question is, if we start with how learning works and where the learner is, lectures are not very fruitful. There’s a huge body of expertise and knowledge in a lecture but it’s like rereading and underlining and highlighting and taking notes. That’s trying to get it in. It didn’t work too well. So what you want is someone who knows and understands the depth of it to find out where you are and your understanding and pull you forward by asking you to explain things or try to connect new ideas to what they know to various forms of exercises. I think the days of long lectures are kind of gone. They’ll be on video and they’ll be able to watch them and hopefully, you will go through a few minutes of the video and then it’ll stop and say “Now, what did you just hear?” And you’ll try to retrieve what you just heard and then it’ll go on a little further that you’ll be asked again to retrieve what you heard. Very different from going into a class and listening to somebody speak for an hour.

Peter Horneffer: Exactly as you know that’s been our approach at Lecturio to use short videos of five to no more than nine or 10 minutes interspersed with recall questions. I clearly think there is an advantage to helping students understand material in video format and mixing up reading and various input. But as you say what really makes it stick—and I love your book is so well titled, it’s so intuitive—is to have these concepts remain in the mind not only for preparation of boards and to be able to do well on exams but especially in the medical field. It’s crucial that young physicians have a good knowledge base when they see a patient. They can’t excuse themselves and go look something up or scrub out of surgery. It’s important that they have a very solid foundation and that they can retrieve these concepts. So I think that’s why it’s so helpful about your “make it stick” concepts. One of the tools you talk a lot about is calibration. Can you describe that a little bit further?

Peter Brown: This comes out of this notion that our intuition is not a reliable indicator of what we know and can do as one of the reasons that pilots have instruments. You know, in flight, your vestibular reflex will tell you that you’re flying level but the astronaut will say you’re not flying level and you need to know what your instruments are as a learner. Being asked to demonstrate that you know something or can do something through quizzing, self-quizzing, quizzing in a class, other forms of retrieval and application help reveal that whether you are on top of it or whether you’re not. It’s very important as a student to build these kinds of credits to your result, so it’s not long under an illusion of mastery or illusion of knowing something that you really, in fact, cannot explain or cannot demonstrate. That’s what we call it recalibrating your judgment of learning, what you know one can do and then “yes I got that right, but I see over here this is something I need to spend a little more time working on because I don’t quite have it the way I should.”

Peter Horneffer: As you know, Lecturio provides its learning platform to schools around the world. If “Make It Stick” concepts are properly applied, do you think these concepts should work equally well for individuals with different educational and cultural backgrounds?

Peter Brown: They will, for sure. The way people learn, the fundamentals of encoding new knowledge, consolidating it, retrieving it, building those connections, that’s all universal of the human being. We also understand that—to learn something new—you have to be able to connect it to something that you already know. So, for every individual, any given topic, they kind of need to start from where they are and build on that. And so you have differences in that regard. You need some way of starting knowing where people are going from there forward. There also are cultural differences that you need to find ways. I’m sure this might be language. Some of the research that’s been done in different cultures has shown some students who scored very low on the IQ scale in schools have a very sophisticated mastery of math and social dynamics, because they’re living their lives in the streets and they’re doing street businesses and they’ve mastered all of this but they don’t do well by ordinary Western measures.

So the learning system is the same, the learning process is the same. And the ability to reach them, where they are—both geographically and intellectually in terms of their not current knowledge base—and go from that knowledge base and coach them forward. And it should be universal.

Peter Horneffer: You describe different types of intelligence, like practical intelligence, creative intelligence and analytic intelligence—with this last being the form of intelligence that leads naturally to doing well on medical board exams. So it sounds like you’ve found that students with deficits who are not naturally inclined to analytic intelligence could ultimately learn as well as students whose upbringings led to this kind of analytic thinking, is that correct?

Peter Brown: The literature on intelligence and how to measure intelligence is pretty wide. There are a lot of theories about intelligence, but there’s one thing we know: Measuring students’ intelligence is what they know now as compared to their peers at their age or at their rate in school. But other ways are measuring what you know and a subject, going through some kind of constructive learning exercises and measuring again and then what you get is a sense of the dynamic potential of a person to increase their knowledge and skills.

And I think that’s more the direction we’re moving in terms of intelligence. Is this not the notion static of what you know and can do now, but given the kinds of learning tools that we can bring to people now, the dynamic range within, which people can move how well they can move within that range and I think that’s the really exciting part—this sort of shifting going from seeing intelligence as a static IQ number to being a dynamic range and being able to pull people, help people, pull themselves up through that range and see that kind of progress.

Peter Horneffer: I think there are lots of exciting things being examined and new ways of learning and teaching. Your books have been so helpful to many of us to help crystallize these ideas. I’m eager to know, did you have the next book in mind or what do you have in the works now?

Peter Brown: “Make it stick” has been very well received and has kept us busy, but one of the great things is, how many reports we’re getting back from people who are applying these strategies in law school or other settings and the kinds of results we´re getting by independent measures. So what we thought would be useful to people: We have the science, now we have the issue, we apply the science and all of us—as learners and as instructors—are challenged to incorporate these strategies and find ways to do it, that is at least disruptive and most effective. So, we’re looking for stories of people who have done that, put together what we’re calling now a “make a stick tool kit” which is like a catalog of stories of how people have done this and where there’s independent measures or the results reporting those and others that can look through this and see good ideas. It’s like an idea catalog. “Oh look what they did over there, I wonder if I could adapt that” to help people move from where we are to where we need to be in terms of applying strategies based on learning as opposed to teaching.

Peter Horneffer: And as a dean of my school in Jamaica we have “make it stick” posters for the concepts and are applying it and eagerly looking to see the results. […] So thank you for putting this wonderful book together and for joining us today and look forward to working with you in the future as we all explore this new territory.

Peter Brown: Thank you. Peter, I’m fascinated by Lecturio and by your work in Jamaica and elsewhere, it’ll be great to follow your progress. Thanks very much for this opportunity to chat.

Watch the second part of the interview