Not all hard work leads to learning.

Student pharmacist development is becoming increasingly dependent on higher-order learning which may likely require adaptive changes in learning strategies. Most students, past and present, did not learn learning strategies in a formal setting; they developed or used learning strategies that seemed natural (eg, re-reading, highlighting, summarizing). When those methods were unsuccessful, some students attempted new strategies, and those who were less adaptable at finding new learning strategies may have been less successful in their courses. If student success is based on meaningful learning, then efforts need to be made to increase student learning. If students do not understand how they as adults learn, their development and success as professionals, thinkers, and life-long learners may be limited. Dr. Stephen Chew, one of the United States Carnegie Professors of the Year in 2011, discussed the role of educating students on how we learn. He states that students often use strategies that are ineffective or inefficient, and he tries to teach them how to identify optimal study strategies. By doing so, he hopes students can maximize their study time. He goes on to state that “engagement alone, however, is not sufficient for learning, and although learning is hard work for students, not all hard work leads to learning.”1 For example, a study surveying college students’ study strategies found that 84% of undergraduates at a high level institution (average SAT 1400) used rereading as a primary study technique, and most students would choose rereading over practicing recall through self-testing.2 However, the overall effect of rereading on learning is low, while self-testing tends to be higher.3 Within pharmacy, several studies have approached the subject of learning based on learning strategies,4,5 but studies examining the impact of teaching learning strategies tend to be more common at the undergraduate level.6-8 Most notably, intervention studies have shown increased student success and retention when students are trained on how to learn. Within medicine, one study showed that student learning strategies, particularly skills of self-testing and time management, predicted first-year performance.9 Most recently, an article published in Psychological Sciences in the Public Interest reviewed the most impactful study practices.3 The investigators found that high-yield strategies included distributed practice and self-testing and did not include rereading, highlighting, or summarizing. Many colleges and schools of pharmacy are updating their curriculum, focusing on active learning to achieve higher-order learning goals; new colleges and schools of pharmacy are designing curricula with the same intention. If pharmacy educators are going to ask more of students, we need to focus on instructional methods and student learning strategies that will enable them to become what society is demanding of them. Appropriate learning strategies can reduce the rate of forgetting, thus increasing retention of material. The issue of learning strategies may be further confounded as more faculty members are using technology (eg, videos, animation) to deliver foundational content. There is some belief that learning from video and learning from text are not similar skills sets.10,11 Teaching students how they learn is an important concept that should be incorporated into the pharmacy curriculum. Although this may seem like a large endeavor, it could be accomplished in several ways. Some examples include: having a short activity or lecture (ie, 1 to 2 hours) in an introductory pharmacy course during the first year, either just prior to examinations or at the start of the semester; providing print or online material easily accessible for ad-lib use; or conducting formal courses in learning. If students are taught how to learn early in the curriculum, they will be more likely to excel throughout their academic careers, as practitioners, and as life-long learners. We ask our students to teach patients and other practitioners, now and in the future. We ask students to teach each other through in-class presentations or cooperative learning strategies. We ask students to serve as peer-tutors or teaching assistants. However, as we focus on students’ ability to apply, evaluate, create, or communicate information, we may need to teach students how they learn so they can be more effective learners—and ultimately teachers—themselves.