Practice Perfect 822
The One-Pager

In Practice Perfect 756, I discussed recommendations for how students should study during rotations. I still find those recommendations helpful, so I suggest students take a look. Perhaps not surprisingly, an addition to these recommendations is also helpful for residents: the one pager.

It often surprises me just how inefficient many of my learners are with their studying. I’m entirely certain that I was just as inefficient when I was a student and resident and looking back, I sometimes wonder how I made it through my training having learned anything! I thought I “knew it all” back then, but the older I get the more I realize how poor a learner I actually was. If I could go back and do it all again my methods would certainly be different. Today, when working with residents in my program, I’ve become somewhat more tyrannical in forcing them to adopt a particular method during our academic sessions called the One Pager. This is a method to create a study document that may be referred to later to make resident studying more efficient and effective. 

I have to give credit to two individuals who brought aspects of this to my attention (this isn’t my idea at all – much smarter people than me came up with these ideas). Lawrence Harkless, DPM, founding dean of the WesternU College of Podiatric Medicine taught students to “read to completion” where he listed certain subtopics within a primary topic students should read and document when studying (see below). Denten Eldredge, DPM, suggested our residents with the Chino Valley Medical Center residency create a single document, boiling down the most important points during our academic sessions, encompassing the main topic of the month (the residency has a single podiatric topic each month covering all pertinent disorders during the 36-month training). These excellent ideas created the foundation for a potentially effective learning and studying method – as long as learners take advantage of it!

When creating the one-pager, the sections you will cover for any single pathology are as follows. 

Clinical Presentation
Nonsurgical Treatment
Surgical Treatment
Outcomes and Complications

Creating a document is actually very easy. First, keep a document open as you read a particular source. As you read, write down the main important facts for each section as you come upon them. Remember to keep the information short and concise. Second, think about the information and what it means. You’ll find this will stimulate more questions that will require further research into the medical literature (something residents should be doing every single day of their residency). The entire idea of this is to create a concise reference document that covers a topic in detail, so you never have to go back to those original sources. Remember, we’re looking for efficiency since residents don’t have time to reread sources multiple times. 

The one-pager is a concise reference document that covers a topic in enough detail that you almost never have to go back to the original sources.

I added a references section at the end because you never know when you have to find an original article. As I do some lecturing, it’s important that I’m able to find the original citation.

What method you use to create the document is entirely up to you. I like a program called Notability, which allows the use of a stylus to write notes. Additionally, the format you use is also your choice. You can use a linear style or even something less structured, such as a mind map with lines connecting ideas like the spokes of a wheel. It’s entirely up to you – use what works best. Whatever method you use, though, it should be fast and efficient. 

Click on the link for a basic example. The topic of this month for my residents is Charcot arthropathy. As I read our assigned literature, I took notes. You’ll notice my document is incomplete and pretty rough looking, and there are lots of topics still to add. This document represents information acquired after two sittings (reading a McGlamry chapter and looking up an article about the pathophysiology of Charcot), so there’s still a lot to fill in, but it’ll give you the idea.
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I have two final pieces of advice to close out this discussion. First, keep a “Questions” area available to jot down topics and questions that you’ll look up later to fill in the blanks in your knowledge. Second, consider working as a team with your coresidents to create these one-pagers together. As your residency progresses, fill in the blanks as future questions arise, and new information is learned. By the end of your program, you will have created the only source you will need to study for board exams. 

Best wishes on your future studies.

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]

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