Deductive Reasoning

One of the greatest challenges in teaching sonography lies in encouraging students to develop the skill of deductive reasoning. This form of thinking involves drawing conclusions from facts and being able to recover and logically manipulate them to correlate with the clinical questions at hand. Logic represents an important tool that is especially useful in the practical phases of the creative-thinking process, when an individual is evaluating ideas and preparing to apply them.

Effective Listening

Students who want to learn must increase their reading rate and listening skills. People rarely listen with maximum efficiency, and they consciously pay attention to only a fraction of what they hear. The average speaking rate has been measured at approximately 125 words per minute, whereas the average listening and thinking rate is 400 words per minute.¹ Such a large time lag encourages the mind to wander. Successful students must develop methods to increase their attention span by becoming effective listeners. Hearing and listening are not the same thing; listening is a cognitive act that requires you to pay attention and mentally process what you hear.

Immediate Memory

Immediate memory is the least understood and most often overlooked of the three types. It is used to remember things only long enough to respond to them. Reading this page is an example of immediate memory. Each word that is read remains just long enough in the individual’s immediate memory to make the transition from one word or idea to the next. Many of the words just read were discarded immediately, but they had to be remembered long enough to make sense out of them.

Immediate memory is extremely limited. People can respond to only one thing at a time, and information retention is limited to only two to four items.² Another problem with immediate memory is that it requires singular attention to determine which items require prompt response and which items require transfer from the immediate memory before they decay and are lost forever.

Short-Term Memory

Short-term memory comes into play after the information has been selected as important enough to remember. It sometimes is called “working memory,” because it is the system used to remember information that must be recalled or responded to within seconds or minutes after receiving it. Short-term memory is what people use to look up a telephone number and remember it only long enough to dial. The basic difference between short-term and immediate memory is that short-term memory allows people to remember several things at once, for periods of time greater than 1 second. Short-term memory is a limited system, capable of remembering only a maximum of seven items at a time. Short-term memory also is subject to rapid information loss, although not as rapid as that of the immediate memory. Because disturbances can cause memory loss, short-term memory can become overloaded, causing us to forget “everything” taken in at the time of the overload. This is why developing reasonable study schedules and study breaks rather than “cramming” is encouraged.

Long-Term Memory

Long-term memory is used for information that must be stored for long periods (days, months, years) before use. Retrieving information from the long-term memory collection requires a search. If the long-term memory is unorganized, a big load is placed on the short-term memory. For this reason, processing incoming information correctly is important; otherwise, it will be irretrievable. The major advantages of the long-term memory system are (1) its limitless capacity to store information and (2) the number of items it can retain. Long-term memory facilitates learning and the memorization of new material. It is believed that the more information stored in long-term memory, the easier it is to enter new information.³

Storing information in long-term memory requires attention, organization, and association (Figure 2-1). Attention is focusing on desired material and blocking out any disturbing stimuli. The primary purpose of attention is to determine what is important enough to remember. Organization is the art of putting memory in order. The human mind is like an expanding library ofall previously acquired knowledge, stored by appropriate categories. Every time new knowledge is acquired, it is added to any associated facts that were stored previously, always available to be checked out. If a particular category of facts is used or added to only infrequently, it is treated as inactive and displaced to make room for new or additional facts. This process is unfortunate because inactive information sometimes is difficult to locate or may even become lost.

One popular method of remembering things is called association, a technique that involves forming a meaningful connection with a fact. This activity encourages learning and thinking more about that fact. As a result, the more facts associated with a particular memory, the more permanently those facts will be stored.

Inaccurate Memory

Humans have a tendency to alter and distort details when some parts of a memory fail to fade in a uniform manner. These parts of memories are held together but with missing or altered details. Sometimes the desire to make our memories more appealing causes us to distort the reality of events and experiences. By doing so, we support our beliefs, values, notions, and hopes, and we defend our prejudices. Often we add details to our recollection of events to complete and make sense out of sketchy or incomplete memories. By filling in and rounding out missing details, we can create a memory that is satisfyingly whole or complete.

Although complete elimination of inaccurate remembering is impossible, certain strategies can facilitate an accurate memory. The key lies in remembering well and correctly. Students can take notes to ensure the information they want to recall is remembered accurately. Understanding a subject clearly from the start makes errors in thinking much less likely. It has been proven that memories improve also if the body is prepared for the task.⁴ Rest, sufficient sleep, and healthy eating habits (particularly eating breakfast) improve the brain’s ability to function.

Forgetting

Failing to recall a name or a fact for a test is frustrating. If you were unable to forget anything, however, the constant remembrance of pain, disappointment, and trauma would make life intolerable. Forgetting is a critical survival mechanism that allows the memory of painful experiences to lessen somewhat in intensity and eventually to fade. High pleasure and pain levels enhance remembering, making it possible to retain painful physical or emotional memories and to remember them when needed. When the rewards of remembering do not reach such highs, people have a tendency to forget. This characteristic explains the common failure to remember names, dates, places, and material that really was not understood initially. Furthermore, it illustrates the importance of interesting learning materials; otherwise, the individual must find artificial ways of remembering factual data.

Memorization

Memories can be stimulated consciously and subconsciously. Health care professionals often relate how the sensory triggers of sight, sound, touch, and smell are associated frequently with a particular patient or disease. Although these factors were not memorized intentionally, they still were registered in a subconscious fashion.

Conscious or intentional memorization occurs only when people deliberately and systematically devise ways to recall specific facts. As such, it relies heavily on perception and attention.

Perceptions are influenced greatly by previous memories; therefore possessing a memory bank rich in similar information increases the accuracy of perceptions. The mind is a computer-like processor of information and a museum that stores past experiences and images. Thus, when sonographers scan patients, the brief appearance of a partial shape or prominent echo-pattern often is sufficient to trigger recognition. Experience has shown that any increase in such memories is proportional to the length of the sonographer’s scanning activity. During a sonographic examination, each time information is displayed on the viewing monitor, it also is stored in the sonographer’s memory. In addition, sonographers who have logged many transducer hours reproduce their perceptions of patients’ anatomy more rapidly and with greater detail and accuracy than do novice sonographers. Veteran sonographers subconsciously demonstrate their ability to retrieve data from a large body of organized and synthesized information.

Although attention requires concentration and a sharp focus on a specific fact or activity, concentration requires discipline and vigilance to ignore interfering thoughts or distractions. An individual can improve the ability to concentrate by preparing to receive new information and learning something about the subject in advance.

Memory Techniques

People commonly use memory aids when confronted with a large volume of new or unfamiliar information or an inadequate amount of time in which to learn that information. The memory techniques most often employed are clustering, association, visualization, and mnemonics.

Clustering is a method of memorizing long series of data by arranging them in segments. Usually it is easier to remember numbers grouped in segments of three to five. This is how people recall telephone numbers, Social Security numbers, and zip codes. Rhyming also can make remembering easier. When facts or phrases are set to music, they are easier to recall. Examples are the songs used to master the alphabet (i.e., “The Alphabet Song”) and numbers (e.g., “One, two, buckle my shoe…”).

Visual or verbal associations bridge memory gaps and enhance remembering. Figure 2-2 shows some examples of association. The most successful associations are tied to prior knowledge. For instance, someone may choose to remember the number of white and black keys on a piano (52 white keys and 36 black keys) by associating them with the 52 weeks in a year and 36 inches in a yard. Sometimes, the similarities in spelling two different words can cause memory difficulties. For example, with the words stationery and stationary, it may be helpful to remember that the “e” in stationery stands for letters, whereas the “a” relates to movement.

The use of acronyms, initials, and acrostics can make material meaningful by gathering information into mnemonic clusters to reduce the amount of information to remember. For example, the names of the Great Lakes form the acronym HOMES, which stands for Huron, Ontario, Michigan, Erie, and Superior. Acronyms and initials are used widely to represent associations, organizations, government agencies, and military titles and terms (Box 2-1).

Another popular mnemonic technique involves creating a rhyme or story that contains the facts to be remembered. We often use the following rhyme to remember when to begin and end the use of daylight savings time: spring aheadfor the move to Daylight Savings Time in the spring and fall back for the return to Standard Time in the fall.

First-letter mnemonics, or acrostics, support recall by creating a sentence in which the first letter of each word is a prompt for recalling information. Medical students traditionally have used this acrostic: On Old Olympus Towering Tops, A Finn And German Viewed Some Hops, to remember the 12 cranial nerves: olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, acoustic, glossopharyngeal, vagus, spinal accessory, and hypoglossal.

The memory technique that works best for remembering concrete objects and actions such as the items on a shopping list is imagery, or visualization. A major drawback to this technique is that it works poorly on abstract concepts (e.g., justice and mercy). Whenever ultrasonic equipment controls are mentioned, most sonographers visualize an instrument console and each control discussed. Hearing a sonography term such as increased gain may trigger the memory of an ultrasound scan filled with predominantly bright echoes.

The obvious value of memory aids is that they make people organize, associate, and visualize meaningful information, forcing them to concentrate and pay attention. The painful truth is that the things people understand do not require memorization; people only memorize the things they do not understand. Box 2-2 suggests steps to enhance your memory.

Effective Learning

Much of the time people listen inefficiently. Although listening is the communication skill used most often, it is the one in which people have been given the least training. This presents a serious problem, because the end product of listening is knowledge.

Listening involves sensing, and it goes beyond hearing or assessing only the spoken words. Good listeners think more broadly because they hear and understand more facts and points of view. Because good listeners look at problems with fresh eyes, they combine what they learn in more unlikely ways and are apt to develop new and valuable ideas. If given a choice, effective listeners focus on ideas rather than facts, because facts can be resurrected later.

Two important mental functions in effective listening are recall and comprehension. Recall involves memory. It is the ability to restate what is heard at a later time. In contrast, comprehension involves mastery of what is heard, meaning that it is thoroughly understood and intelligently applied. A special kind of listening occurs when people are silent, attentive, and receptive. In this state, the mind mulls over, interprets, speculates, posits, and reviews incoming information. To be an effective listener, you must be motivated. In other words, you must have an interest in or reason for listening to what is being said. Effective listeners listen without prejudice to avoid ignoring or filtering out details or tuning out any speakers who do not match their own ideas or values.

Sonography students who want to get the most out of classroom lectures must come to class prepared to listen. If all lesson assignments have been completed, they can concentrate on the subject being discussed. Students also should view classroom lectures as give-and-take sessions between the instructor and students and use class discussion as a means of getting the facts straight or asking for explanation of any puzzling concepts.