Reading to learn


  • Many people read by passively reading through text from start to finish, perhaps with a highlighter in hand
  • This page includes advice and techniques for reading more effectively, in order to develop understanding and improve retention of information


Peter Rosen, in an interview on the RoshReview podcast, advised reading to learn medicine in four ways:

  • Read from fear
    • if there is a condition or situation that you are afraid you can’t handle, then spend 10 minutes reading about it before your next shift
  • Read from curiosity
    • read about topics that you are interested in
  • Read from experience
    • read about the conditions and situations you encounter in clinical practice, this will help you make sense of your experience, provide ‘hooks’ on which you can hang new knowledge, and provide an opportunity for reflection
  • Read for pleasure
    • generally this will not involve medical textbooks!
    • The raw material for medical practice is the human condition in all of its facets
    • There is much to be learned about this from works of fiction as well as non-medical non-fiction books

He advised never to read a medical textbook cover-to-cover (you’ll retain <2% of it that way!)


Learning science suggests that commonly used methods of learning content from reading are largely ineffective (Dunlosky et al, 2013).

These low yield methods include:

  • passively re-reading text
  • highlighting text
  • passively summarising text


A more useful approach to learning content from reading is the SQ3R approach

  • the core of the technique is asking questions first and then reading actively with the aim of answering those questions
  • The SQ3R method was introduced by Francis Pleasant Robinson, an American education philosopher in his 1946 book Effective Study
  • Similar techniques that were subsequently developed include PQRST (Preview, Question, State, Test) and the KWL table (know, want to know, and learn) approach

Steps (relevant concepts from cognitive science and educational psychology are indicated in bracketed italics):

  • Survey the section to check the relevance of what you are about to read (determine knowledge needs; generation)
  • create a set of questions that you want to answer based on the survey (generation)
    • Generate questions based on the heading, tables and images in the text
    • Ask yourself what the section you are reading is about:
      • “What are the questions that the author is trying to answer?”
      • “What questions do I have that the section might help answer?
      • “What questions might I be asked about this topic?”
    • It is useful to write the questions down (:SQW3R”)
  • Read actively; anticipating the answers to the questions you created and paying particular attention to new knowledge and surprising findings (generation)
    • Actively search for the answers to your questions
    • Read reflectively; consider what the author is trying to say, and think about how you can use that information
    • Be alert to emphasised text (e.g. bold or italicised print)
    • Pay particular attention to tables, graphs and illustrations that often convey an idea more powerfully than written text (and are easy to make exam questions from!)
  • Recite the questions and attempt to answer them with explanations (utilise the Test effect and provide elaboration)
    • stop reading periodically to recall what you have read
    • recite out loud or by writing down answers to your self-generated questions
    • Try to recall main headings, important ideas of concepts presented in bold or italicized type, and what graphs charts or illustrations indicate
    • Try to develop a ‘big picture’ understanding of the concepts you have read about
    • Connect new knowledge to things you already know
    • do not regurgitate phrases word-for-word from the text!
  • Review; periodically revisit and retest yourself on the question-and-answers (can be performed using spaced repetition and provides an opportunity for reflection and calibration)
    • ideally, do this after each section and after completing the reading assignment, then revisit as part of a spaced repetition programme
    • review your questions and try to self-generate the answers
    • re-read the relevant text if you cannot answer correctly and your notes are not sufficiently clear
    • flashcards or spaced repetition software can be used

Journal articles

FOAM and web resources

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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