A steep ‘forgetting’ curve?

There are likely to be a lot of unfamiliar new faces around you at the moment. FY1’s are taking their first steps after completing Medical School. FY2’s are starting their next rotations. The latest recruits are beginning their various specialist and core training programmes. And it won’t be long before the newest batch of university students turn up. We’ll often say that they are on a steep learning curve. But, if you are involved in supporting their development, whether formally or informally, then there’s another important question to consider.

How steep is their forgetting curve?

It happens to us all. You’re a qualified doctor. So, you must have passed your university exams in a broad range of subjects. How well would you get on if you were to re-take these exams today? Would you pass with flying colours as you once did? Or would there be fundamental gaps in your knowledge or skills?

Our initial learning curve is quickly followed by a forgetting curve. This was described by Hermann Ebbinghaus way back in the 1880s. He even proposed algorithms to describe the curve’s decay rate.

We see this forgetting curve played out over short time-scales with regular frequency during our Teach the Teacher Courses. Our delegates each have several opportunities to practise teaching their fellow delegates. So they also have numerous experiences of being taught, learning new skills or new information. It can be remarkable to see what they manage to achieve in just 10 minutes. And it can be surprising how little they have retained just half an hour later.

Optimise learning. Minimise forgetting.

Without doubt, there’s a lot to be learned. So, you have a lot to teach. All too often, this means we go too fast. We try to ‘maximise’ learning, to get as much done as quickly as possible.

Let’s consider the idea of “See one. Do one. Teach one.” It’s a fairly common phrase in the medical world. But is it really a good recipe for the consistent transfer of skills? The forgetting curve means the output of this approach is more likely to be, “See one. Do one. Forget one.” Even worse, it could turn out to be, “See one. Do one. Teach something that isn’t actually correct.” And the consequences of that should immediately set alarm bells ringing.

Clearly, the learner has a significant responsibility here. The teacher can’t actually do the learning for them. But, at the same time, the teacher’s approach can make a significant difference.

Think of the last time you were teaching someone something. How would you describe the balance of your focus in the following two domains:

  1. Acquiring knowledge or skill
  2. Retaining the knowledge or skill

We’re wasting our time if what we teach isn’t going to be retained. So, it makes more sense to try to ‘optimise’, rather than rushing to ‘maximise’ learning. At the same time, it’s important to take steps to minimise forgetting. A well judged pace for initial acquisition, combined with an appropriate degree of repetition and assessment over a period of time is always going to be more effective than “See one. Do one.”

But you might think, “Doesn’t this idea of minimising forgetting sound negative?”

A positive alternative

Understanding the realities and reasons for the forgetting curve helps to clarify the issue. The positive alternative to ‘minimise forgetting’ is to ‘maximise retention’. Focus on pace, repetition and assessment is just one consideration in achieving this. A teacher whose approach is firmly grounded in all the theories of adult learning will aim to facilitate efficient acquisition and help to maximise retention.

What steps are you taking to manage both learning and forgetting curves of the doctors you are supporting?

Stephen McGuire – Managing Director