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Understanding Excellence: a Qualitative Analysis of High-Performing Learner Study Strategies



Remediation in medical education tends to focus on the struggling learner. However, understanding successful learners may provide valuable insights to problematic academic behavior. This study explored core study strategies reported by high-performing medical school students.


In the Fall of 2018 and 2019, high-performing first- and second-year medical students, defined as those who had performed over 90% on a national standardized assessment, were requested via e-mail to describe the study strategies that they believe contributed to their success. Student responses were analyzed using a template-driven approach, which drew upon common frameworks from cognitive learning theory.


Thirty-seven high-performing students provided brief unstructured descriptions of their study strategies. Retrieval practice—the cognitive learning strategy of attempting to draw out information to active recall, typically through means of self-quizzing, practice questions, or flashcards—was the most commonly endorsed strategy, followed by spaced repetition. Use of outside commercial resources was commonly referenced, and approximately one-third endorsed a perception that some form of regularly practiced self-care contributed to their academic success.


Retrieval practice, particularly combined with some form of spaced repetition, is often attributed as contributing to the success of high-performing learners. The use of commercial resources bears further exploration and consideration. Finally, the finding that self-care was identified as a contribution to academic performance goes beyond a focus on self-care solely for medical student well-being. This is an important distinction for both medical education and future research in this area.

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Data Availability

Data is stored at the Uniformed Services University by the corresponding author and is available upon request.


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Correspondence to Ryan R. Landoll.

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This article was authored by employees of the US government. The opinions and assertions expressed herein are those of the author(s) and do not necessarily reflect the official policy or position of the Uniformed Services University or the Department of Defense.

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Landoll, R.R., Bennion, L.D. & Maggio, L.A. Understanding Excellence: a Qualitative Analysis of High-Performing Learner Study Strategies. Med.Sci.Educ. 31, 1101–1108 (2021).

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  • Medical education
  • Remediation
  • High-performing learners
  • Academic success