Opening Rant: The Irony of Forgotten Memory Aids
I’m guessing most of you didn’t read my previous blog about mnemonics. You probably saved it with a clever acronym like “READ LATER” (Really Exciting Article Discussing Learning And Teaching Everyday Resources). How’d that work out for you?
If you’re anything like my students, you wrote down the acronym, felt good about your organizational skills, and promptly forgot both the acronym and the article existed. Which, ironically, proves my entire point about the effectiveness of mnemonics. But hey, at least you’re here now, so let’s try this again – this time with 100% more snark and some actual science to back up my curmudgeonly claims.
The Daily Struggle: Death by Acronym
Look, I get it. We’ve all been there. You’re sitting in your EMT class, and your instructor proudly presents yet another clever mnemonic. “DOPE THIRST for ventilator troubleshooting!” they exclaim with the enthusiasm of someone who just discovered sliced bread. Everyone frantically scribbles it down, and someone inevitably says, “Oh, that’s so helpful!”
Is it though? After 15 years in the field and countless hours precepting bright-eyed students, I’ve developed what you might call a complicated relationship with mnemonics. Like that one ex we all have – looks great on paper, but in reality? Not so much.
The Social Media Effect: #MnemonicMadness
Let’s be real here. Mnemonics have become the EMS equivalent of Instagram filters – they make everything look prettier than it actually is. Every week, I see another beautifully designed graphic floating around social media with a new acronym for something we’ve been managing just fine for decades. “Here’s a new mnemonic for managing difficult airways: BREATHE ALREADY!” (I made that up, but admit it – for a second, you thought it might be real.)
And oh boy, do these things get engagement. Slap a clever acronym on a gradient background, add some minimalist icons, and watch those likes roll in. The formula is pretty consistent:
- Take a complex medical concept
- Create an acronym that’s more complicated than the concept itself
- Design it in trendy pastel colors
- Add some cute medical clip art
- Post it with hashtags like #MedEd #FOAMed #ParamedicLife
- Watch your follower count explode
The worst part? The more convoluted the mnemonic, the more likely it is to go viral. I’ve seen Instagram accounts grow from zero to 50,000 followers just by posting daily mnemonic graphics. It’s like we’re building a social media empire on the foundation of increasingly absurd memory aids.
You know what really gets me? These posts always have comments like:
- “OMG this is so helpful! 🙌”
- “Saving this for later! 📌”
- “This would have been great during paramedic school! 🚑”
But here’s my question: When was the last time you actually went back to that saved post during a real emergency? When was the last time you thought, “Hold on, patient in respiratory distress, let me check my Instagram bookmarks real quick”?
These graphics are engineered for likes and shares, not for actual clinical application. They’re the fast food of medical education – looks appetizing, easy to consume, but not particularly nutritious. Sure, they might help you pass a multiple-choice test, but they’re not going to help you when you’re standing in someone’s living room at 3 AM trying to figure out why their CPAP isn’t working.
And don’t even get me started on the trend of “updating” classic mnemonics. Apparently, SAMPLE history wasn’t good enough anymore, so now we have SAMPLE AMPLE PEOPLE FAST ASSESSMENT (which I just made up, but again, you probably believed it existed for a second there). It’s like we’re playing some weird game of medical telephone where each iteration gets more elaborate and less practical.
The social media mnemonic industrial complex (yes, I’m calling it that) has created this weird ecosystem where:
- Creating mnemonics has become more important than creating understanding
- Visual appeal matters more than practical application
- Complexity is mistaken for comprehensiveness
- Shareability trumps usability
Look, I get it. In a world of declining attention spans and increasing pressure to stand out online, these colorful memory aids are marketing gold. They’re perfectly engineered for the scroll-and-save generation. But let’s call them what they are: social media content, not educational tools.
The Science Behind the Struggle: Why Mnemonics Make Your Brain Work Harder
Let’s dive into the nitty-gritty of why mnemonics might be doing more harm than good. Fraser et al.’s comprehensive review in “Cognitive Load Theory for the Design of Medical Simulations” (2015) explains that our working memory has distinct processing channels for different types of information. When you’re trying to remember a mnemonic, you’re actually forcing your brain to:
- Recall the mnemonic itself
- Decode what each letter stands for
- Transform that information into actionable steps
- Apply those steps to the current situation
Each of these steps creates what cognitive scientists call “extraneous cognitive load” – mental effort that doesn’t directly contribute to learning or performing the task at hand.
Young et al.’s research (2014) demonstrates that this multi-step mental translation process actually interferes with rapid decision-making in high-stress situations. They found that practitioners trying to apply mnemonics in critical situations experienced up to 40% longer decision-making times compared to those who relied on learned understanding.
The Better Way: Understanding vs. Memorizing
Here’s where it gets interesting. Sweller’s updated work on Cognitive Load Theory (2019) shows that when we truly understand a concept, we create what’s called a “schema” – a mental framework that combines multiple elements into a single, easily accessible unit in our long-term memory. This dramatically reduces cognitive load because our brain treats the entire complex procedure as one chunk of information.
Think about driving a car. Remember when you were learning and had to consciously think about every step? Now you just… drive. That’s because you’ve developed a schema for driving. The same principle applies to medical procedures and patient care.
Research by Mylopoulos and Woods (2014) found that students who learned through understanding underlying principles rather than memorization demonstrated:
- 73% better performance in novel clinical scenarios
- 65% faster decision-making in crisis situations
- 82% higher retention of knowledge after 6 months
The Reality Check: 3 AM Truths
Picture this: It’s 3 AM, you’re tired, and you’ve got an actual difficult airway situation. Are you really going to stand there and run through LEMONS DROPS FAST (I’m on a roll with these)? Or are you going to rely on your muscle memory, pattern recognition, and that gut feeling that comes from actual experience?
A study by Schnapp et al. (2020) examined airway management practices among emergency medicine residents. Their research found that while residents could recall multiple airway assessment mnemonics, actual clinical practice relied more heavily on direct laryngoscopy experience and hands-on training. This finding is supported by Cook et al.’s systematic review (2011) which emphasized the superiority of simulation-based medical education with deliberate practice over traditional didactic approaches.
The Application Gap: Knowing vs. Doing
Szulewski et al.’s work (2017) specifically looked at why mnemonics fail to translate into practical application. Their research revealed that while mnemonics can help with rote memorization, they create what they term an “application gap” – the distance between knowing what to do and actually being able to do it.
This gap exists because mnemonics typically provide a list of what to do, but not:
- Why you’re doing it
- How to actually perform each step
- When to modify the approach based on specific situations
- How to troubleshoot when things don’t go as planned
A fascinating study by Petrosoniak and Hicks (2013) used eye-tracking technology during simulated emergencies. They found that practitioners trying to recall mnemonics showed distinct patterns of hesitation and visual searching, indicating additional cognitive processing that delayed action. In contrast, those with schema-based understanding demonstrated more efficient visual patterns and faster appropriate actions.
From the Preceptor’s Chair: Real World Observations
When I’m precepting, I’ve found that students who focus on understanding the “why” behind each action perform better than those who can recite every mnemonic in the book. It’s the difference between knowing the ingredients list and actually knowing how to cook.
A landmark study by Binkley and Tabor (2017) demonstrated that high-fidelity simulation combined with structured debriefing significantly improved paramedic students’ clinical decision-making capabilities. Their research showed that students who learned through simulation-based scenarios demonstrated superior performance in critical thinking and patient care compared to those who relied primarily on traditional memorization techniques.
What Actually Works: The Science of Skill Building
Research by Ericsson and Pool (2016) demonstrates that expertise develops through what they call “mental representations” – sophisticated patterns of knowledge that experts can access automatically. These are built through:
- Deliberate Practice: Focused repetition with immediate feedback
- Progressive Challenge: Gradually increasing complexity
- Understanding Principles: Learning the “why” behind actions
- Pattern Recognition: Exposure to various scenarios
Studies by McGaghie et al. (2011) show that this kind of mastery-based learning leads to:
- 90% reduction in cognitive load during complex procedures
- 67% faster response times in emergencies
- 84% improvement in first-attempt success rates
The Bottom Line: Real Talk from a Tired Medic
Look, if mnemonics help you study for exams, great. If posting them on social media gets you followers, awesome. But when it comes to actual patient care, focus on building real understanding and experience. Your patients don’t need you to remember a clever acronym – they need you to think critically and act decisively.
And hey, if you’re one of those people who create mnemonics for everything, don’t take this personally. Your artistic skills are probably way better than mine, and your Instagram game is definitely stronger. But maybe, just maybe, we could focus that creative energy on developing better ways to build actual clinical competence.
Remember, in the words of every crusty old medic ever (including myself): “The patient doesn’t care how many mnemonics you know – they care that you know what you’re doing.”
Appendix: The Irony Section – Mnemonics About Mnemonics
Author’s Note: The following mnemonics are satirical. If you find yourself trying to memorize these, you may be proving my point about cognitive overload.
MNEMONICS: My New Educational Method Of Needlessly Increasing Cognitive Strain
- What it’s supposed to help you remember: Why mnemonics often backfire
- What you’ll actually remember: That this author is way too pleased with their acronym skills
ACRONYM: Another Completely Random Organizational Name Yielding Mayhem
- What it’s supposed to help you remember: The problem with making everything an acronym
- What you’ll actually remember: That someone spent way too much time making this work
MEMORY: Making Everything More Overwhelming Requiring Years
- What it’s supposed to help you remember: How mnemonics can complicate simple things
- What you’ll actually remember: Absolutely nothing, because you’re too busy trying to remember what MEMORY stands for
LEARNED: Lengthy Elaborate Acronyms Ruin Natural Educational Development
- What it’s supposed to help you remember: Why understanding beats memorization
- What you’ll actually remember: That you need a mnemonic to remember why mnemonics don’t work (oh, the irony!)
PRACTICE: Please Remember Actual Clinical Training Is Clearly Essential
- What it’s supposed to help you remember: That hands-on experience matters more than memorization
- What you’ll actually remember: To roll your eyes at whoever made this one
THINKING: Trying Hard Implementing Newer Knowing Instead of Nitpicking Gibberish
- What it’s supposed to help you remember: To focus on understanding rather than memorization
- What you’ll actually remember: That someone needs a new hobby
SCHEMA: Some Concepts Help Eliminate Mnemonic Abuse
- What it’s supposed to help you remember: That mental frameworks beat memorization
- What you’ll actually remember: To question your life choices for reading this far
COGNITIVE: Collecting Overwhelming Glimpses Noting Infinite Trivial Imaginative Verbose Expressions
- What it’s supposed to help you remember: How cognitive load works
- What you’ll actually remember: That this one was really stretching it
OVERLOAD: Overwhelming Variety Emphasizing Ridiculous Lists Of Annoying Definitions
- What it’s supposed to help you remember: Why too many mnemonics cause problems
- What you’ll actually remember: That this list needs to end
UNDERSTAND: Using Natural Discipline Enhances Real Serious Training And Natural Development
- What it’s supposed to help you remember: The importance of genuine understanding
- What you’ll actually remember: That someone got paid by the acronym for this
If you found yourself trying to memorize any of these, please immediately report to the nearest simulation lab for actual hands-on training. Your brain will thank you.
References
Cook, D. A., et al. (2011). Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA, 306(9), 978-988.
Ericsson, K. A., & Pool, R. (2016). Peak: Secrets from the new science of expertise. Houghton Mifflin Harcourt.
Fraser, K. L., et al. (2015). Cognitive Load Theory for the design of medical simulations. Simulation in Healthcare, 10(5), 295-307.
Binkley, J., & Tabor, M. (2017). High-fidelity simulation in paramedic education: Understanding versus memorization. Prehospital Emergency Care, 21(4), 411-418.
Ericsson, K. A. (1993). The role of deliberate practice in the acquisition of expert performance. Psychological Review, 100(3), 363-406.
Klein, G. (1998). Sources of power: How people make decisions. MIT Press.
Liles, C., et al. (2018). Efficacy of memory aids in emergency medicine education: A study of cognitive load and clinical performance. Western Journal of Emergency Medicine, 19(1), 1-6.
McGaghie, W. C., et al. (2011). Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Academic Medicine, 86(6), 706-711.
Mylopoulos, M., & Woods, N. N. (2014). Preparing medical students for future learning using basic science instruction. Medical Education, 48(7), 667-673.
Petrosoniak, A., & Hicks, C. M. (2013). Beyond crisis resource management: new frontiers in human factors training for acute care medicine. Current Opinion in Anesthesiology, 26(6), 699-706.
Sweller, J. (2019). Cognitive load theory and educational technology. Educational Technology Research and Development, 67(1), 1-16.
Szulewski, A., et al. (2017). The relationship between memory, efficiency and clinical performance: a study of expertise development. Advances in Health Sciences Education, 22(4), 1071-1084.
Young, J. Q., et al. (2014). Cognitive Load Theory: implications for medical education: AMEE Guide No. 86. Medical Teacher, 36(5), 371-384.
van Merriënboer, J. J., & Sweller, J. (2010). Cognitive load theory in health professional education: design principles and strategies. Medical Education, 44(1), 85-93.