INTRODUCTION As a part of undergraduate medical training, medical students are expected to remember and master an immense amount of medical knowledge distributed across different topics in various subjects.1 This knowledge is both theoretical and practical across clinical settings and plays a defining role in making a competent healthcare professional.1,2 In continuation, as medical students move from one phase to another, it is expected that they must be able to integrate this gained knowledge with critical thinking to diagnose and devise an appropriate management plan for patients with different medical conditions.2 In other words, mastery of this knowledge is required to deliver effective, efficient, evidence-based, and patient-centered care.3 Finally, to further compound the issue, considering the recent advancements reported in medicine, students must continue the process of remembering factual knowledge.1–3 DECAY IN FACTUAL KNOWLEDGE Knowledge decay in medical education is one of the major challenges a student has to encounter, as it not only hinders their academic performance in examinations but also slows down their learning progress and impacts their confidence.4,5 This knowledge decay happens when information is not actively used or reinforced; the brain (neural connections) assumes that this information is irrelevant, leading to forgetfulness.4,5 In fact, if the knowledge decay process continues for some time without any remedial measures, it can even interfere with the foundational knowledge, which makes it extremely difficult for students to learn advanced concepts. On the patient care front, knowledge decay accounts for misdiagnoses, incorrect treatment protocols, life-threatening scenarios (in emergency conditions), and all this eventually jeopardizes patient care.6–8 MNEMONICS Mnemonics refer to aids or techniques that can help medical students to easily remember information in the field of medical education, where students are expected to master a massive load of information.8,9 Mnemonics aid in the retention of knowledge by simplification of complex medical information into manageable pieces, by establishing a link with existing knowledge, or by activating other sensory systems (namely, verbal, auditory, and visual).4,6,10 These mnemonics play a defining role in reducing the cognitive load (by dividing complex information into smaller parts that can be easily remembered) and improving long-term memory due to repetitive recall.5,6 In fact, these mnemonics help students to recall information in stressful situations (like examinations) and motivate students to actively engage in the learning process, as they take ownership of the learning materials.5,9 With the help of all these mechanisms, mnemonics facilitate the process of retention of extensive amount of knowledge, and the learning process becomes efficient.5–10 BENEFITS OF MNEMONICS Mnemonics improve the ability to precisely remember critical medical information (namely, anatomical structures and their relations, biochemistry cycles, and diagnostic criteria) both during classroom and clinical settings.4,7 The process of information retrieval becomes rapid and pays rich dividends to students during examinations (theory or practical or viva voce) and the management of medical emergencies.5,7 Moreover, as students have to remember less information, there is a significant reduction in the cognitive load, and they even help to retain a large amount of information, that too for longer periods.11 All these help students to improve their performance in examinations and during clinical practice, mainly because students are not anxious that they will forget essential facts.7,8 Eventually, students become confident about their abilities, and they become less reluctant to learn new things even after completion of their training (lifelong learners).4,5 TYPES OF MNEMONICS Acknowledging the fact that our brain is better at remembering associations and patterns, in contrast with isolated facts, mnemonics can be designed in multiple ways to quickly retrieve and reinforce information Figure 1. The most common one is an acronym mnemonic, which is framed by taking the first letter of a set of terminologies that needs to be remembered, thereby creating a new word or phrase.6 The next type is an acrostic mnemonic, where we frame a sentence, in which the first letter of each word represents the first letter of the things that need to be memorized.12 Chunking is another variety where complex information is grouped into smaller chunks to make it relatively easy for medical students to remember. Some students can even use rhymes and songs to ensure that the given information is memorable.13 Another variety is of visual mnemonics, where we aim to associate a concept with some form of image to augment memory recall.10,14 Even though there is a wide range of mnemonics, which type any student opts for depends on their comfort, and they can either stick to just one of them or a combination of them to make it easier for them to retrieve and apply.5,6,12–14Figure 1: Types of mnemonicsPOTENTIAL CONCERNS The use of mnemonics tends to have its limitations, especially because they just emphasize memorization of facts rather than facilitating the deep understanding of concepts.4,13 In continuation, mnemonics can aid in remembering facts or lists, but their application in developing critical thinking, clinical reasoning, problem-solving, or enhancing students’ abilities to integrate different concepts is limited.7,12 It is not easy to design effective mnemonics for all topics, and thus, it is too much for students to apply them consistently. In continuation, there is a definite possibility for confusion or misinterpretation of information, especially when students have made multiple mnemonics.15,16 The art of making mnemonics is a time-consuming one, and in some situations, it won’t be an understatement that some students find it more time-consuming to design and remember mnemonics rather than learning the material directly.16,17 Finally, apart from the standard mnemonics, the process of creating mnemonics is an extremely subjective one, and not everyone can remember the concept using the same mnemonics, and hence, they lack transferability.16,18 Thus, the use of mnemonics must be promoted in balance with other learning strategies to promote both memorization and understanding of concepts in medical education.15–18 BEST PRACTICES FOR USING MNEMONICS Acknowledging the potential merits and concerns of using mnemonics, we must frame best practices to promote rational and optimal use in facilitating the learning process Table 1. To begin with, mnemonics should be used in combination with other active learning strategies (such as problem-based learning and group discussions) to ensure a deep understanding of concepts. Students should be advised to revisit mnemonics now and then (like in group discussions or clinical postings) as it helps in long-term retention of the facts.11–13 Further, students should be encouraged to create their mnemonics customized to their learning styles, as this makes them more meaningful and memorable.17,18 Students must be sensitized that they should first understand the supporting principles and then only resort to mnemonics for recall of factual information.18 The designed mnemonics must be simple and clear, and whenever possible, students can combine them with drawings or mind maps to augment the retention of information.10,12 It is a good practice to periodically review and update mnemonics, especially in accordance with the reported recent developments.19 Finally, students should be motivated to share their designed mnemonics, as it supports remembering complex medical information and promotes deep learning.20Table 1: Best practices for using mnemonicsCONCLUSION Mnemonics play a crucial role in helping students to remember complex factual medical information. It is the need of the hour that medical educators encourage the use of mnemonics to deal with the volatile nature of medical knowledge. However, they must be used in collaboration with other teaching–learning methods to promote both understanding and retention of information.
Saurabh RamBihariLal Shrivastava (Thu,) studied this question.