Wellness and Learning
[Cover image by Pexels on Pixabay]
by Cindy Nebel
While we spend a good deal of time talking about learning strategies and how to balance note-taking, content review, and active retrieval practice, all of those strategies are actually fairly useless if you haven’t taken the time to prepare for learning.
I work at a medical school where learning is a hard job. There is a huge volume of information that students must learn quickly while simultaneously managing research, leadership, and volunteerism in order to prepare for residency applications. The balancing act between all of these requirements can cause a good deal of stress on students. For this reason, even the best students, using the best strategies, working tremendously hard can still falter. Because it turns out that learning requires you to take care of your mental wellness first.
The interaction between wellness and learning operates on working memory. Working memory is the finite space we have to hold onto and manipulate information we are currently working with. It is the space where we connect old information with incoming information, where we reason and problem-solve. Arguably, it is literally where learning happens.
When we are tired, anxious, or overloaded, our working memory suffers.
There is an abundance of research showing that sleep deprivation impacts working memory performance (1). What many medical students don’t realize is that these effects start at a relatively small amount of deprivation, with individuals receiving six hours of sleep per night showing significant impacts on their working memory performance (2). While it has often been seen as a right of passage to sacrifice sleep for the sake of learning, the research clearly shows that getting that extra hour of sleep results in much higher benefits for learning, which becomes more effective and more efficient with sufficient sleep (which is 7-9 hours for most adults).
A common reason why medical students struggle to get enough sleep is stress or anxiety. As mentioned above, there are many demands placed on medical students, so it is unsurprising that they might experience some amount of stress. However, too much stress can cause working memory difficulties (3). When we are anxious it signals to our brain that the anxiety-inducing factor is important - probably for our survival. So instead of relying on our top-down attentional control where we decide what we want to pay attention to at any given time, our brain uses bottom-up attention and steals some of our working memory capacity to “look out” for the thing causing us anxiety. This process can happen without our conscious awareness. Anxiety can also cause intrusive thoughts in our conscious attention, which again steals capacity that could be used for learning.
It may seem inevitable that learning is going to suffer, but there are many things we can do to manage anxiety and improve wellness to limit these impacts (4). Healthy living in general promotes better mental health. Here sleep is another critical factor. In addition to providing learning benefits, sleep is a mood stabilizer, increasing positive emotions. While exercise has cardiovascular benefits, it also provides considerable benefits for mood. Nutritious food has also been shown to improve psychological well-being and, in turn, academic performance. Finally, social support is a critical factor in creating better mental health. Often, medical students begin to isolate as their anxiety increases, which in turn makes the anxiety and learning worse. This can begin a negative spiral if it isn’t recognized and remediated.
Another common misconception among medical students is that working longer and harder will result in better learning, but how students structure their learning and taking frequent breaks can often result in better long-term retention. As we take in new information, we can become cognitively depleted, so taking effective breaks that involve a little exercise or meditation can be really effective for resetting the system. What you don’t want to do is jump on social media, where you are both taking in new information and potentially ramping up anxiety.
Learning is sometimes a counter-intuitive process. While it may seem like sacrificing sleep, exercise, or time with friends is necessary to increase time spent learning, the research shows that these very things enhance the learning process. This is great news for all the students out there. It’s like being told you can have your cake and eat it too. You will actually learn more if you are a better adjusted human, so have a nap and a walk and go see a friend in between study sessions. It’s worth every minute.
References:
Frenda, S. J., & Fenn, K. M. (2016). Sleep less, think worse: The effect of sleep deprivation on working memory. Journal of applied research in memory and cognition, 5(4), 463-469.
Van Dongen, H. P., Maislin, G., Mullington, J. M., & Dinges, D. F. (2003). The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep, 26(2), 117-126.
Moran, T. P. (2016). Anxiety and working memory capacity: A meta-analysis and narrative review. Psychological bulletin, 142(8), 831.
Dai, P., Yi, G., Qian, D., Wu, Z., Fu, M., & Peng, H. (2023). Social support mediates the relationship between coping styles and the mental health of medical students. Psychology research and behavior management, 1299-1313.
