Name: 學校不教的學習祕訣（超越你的同齡人） (The Study Secret They DON'T Teach in School (Outthink Your Peers))
Uploaded: 2025-06-17T15:09:04.000Z
Duration: 10 min 19 s

程度副詞

A plastic surgery attending during my away rotation as an MS4 asked me a question that completely stumped me.

在我作為四級醫生外出輪崗期間，一位整形外科主治醫師問了我一個問題，這個問題完全把我難住了。

I wanted to have the correct answer for the attending, but I hadn't studied this yet.

我想為主講人提供正確的答案，但我還沒有研究過這個問題。

The adrenaline started to kick in, but even though I didn't know the answer, I still managed to impress him.

腎上腺素開始分泌，儘管我不知道答案，但還是給他留下了深刻印象。

Because of one key tactic that helped me not only when I was pimped in the OR, but also to crush exams over and over again in medical school.

因為有一個關鍵策略，它不僅在手術室裡幫我拉皮條，還在醫學院裡幫我一次又一次地戰勝了考試。

But before I tell you how I answered the ear question, you first need to understand why average students score average marks.

但在我告訴你我是如何回答耳朵問題之前，你首先需要了解為什麼成績一般的學生會得平均分。

Most med students try to brute force their way through medicine by memorizing everything.

大多數醫科學生都試圖通過死記硬背的方式來學習醫學知識。

But top students, they think differently.

They apply frameworks, reason through tough situations, and don't panic when they don't know the answer.

他們運用框架，在困難的情況下進行推理，不知道答案時也不會驚慌失措。

Today, by watching this video, you'll learn how to do just that and why it matters.

今天，通過觀看這段視頻，您將瞭解如何做到這一點，以及為什麼這一點很重要。

這就是為什麼單靠背誦會失敗的原因。

First, patients don't come with multiple choice options.

Second, exams reward pattern recognition and logic, not just recall.

其次，考試獎勵的是模式識別和邏輯，而不僅僅是記憶。

And third, you'll get pimped on stuff you haven't seen, and your ability to reason matters more than what you've memorized.

第三，你會因為沒看過的東西而被拉票，你的推理能力比你背誦的東西更重要。

Ultimately, at the end of the day, you can never have every single fact memorized, and reasoning your way to the answer with imperfect information is the only way you can improve your odds of getting the answer right.

歸根結底，你不可能記住每一個事實，在資訊不完善的情況下推理出答案是提高答對率的唯一方法。

So how did I reason my way into correctly answering a question I didn't know?

那麼，我是如何通過推理正確回答一個我不知道的問題的呢？

Going back to the away rotation in the OR when I was asked whether or not ears have muscles, I didn't know the answer off the top of my head.

回到手術室的客場輪換，當我被問及耳朵是否有肌肉時，我並不知道答案。

At first, I thought, damn, I wish I had studied the ears earlier, even though it wasn't a subject I was currently on and this wasn't a scheduled case I could have prepared for.

起初，我想，該死的，我要是早點學習耳朵就好了，儘管這不是我目前正在學習的科目，而且這也不是我可以準備的預定案例。

But then, instead of panicking or immediately saying I didn't know, I leaned on a concept that shows up all over human anatomy, homologous evolution.

不過，我並沒有驚慌失措，也沒有馬上說我不知道，而是藉助了一個在人體解剖學中隨處可見的概念--同源進化。

I reasoned out loud that if animals like cats and dogs can move their ears, they must have muscles dedicated to that function.

我大聲推論說，如果像貓和狗這樣的動物可以移動耳朵，那麼它們一定有專門用於這一功能的肌肉。

Given our shared evolutionary ancestry amongst mammals, it's likely humans have similar ear muscles.

考慮到我們的祖先都是哺乳動物，人類很可能也有類似的耳部肌肉。

They've just atrophied or become vestigial over time.

它們只是隨著時間的推移而萎縮或變得殘缺不全。

After all, the appendix is a vestigial organ that served our evolutionary ancestors, so it's not unreasonable to assume that something similar happened here.

畢竟，闌尾是為我們的進化祖先服務的一個殘留器官，所以假設這裡也發生過類似的事情也不無道理。

That explains why most people can't move their ears, but every now and then, you meet someone who can.

這就解釋了為什麼大多數人的耳朵不能動，但偶爾也會遇到能動的人。

The attending told me, he was less impressed that I got the correct answer and more impressed by how I got there.

主治醫生告訴我，他對我得到正確答案的印象並不深刻，而對我是如何得到答案的印象更為深刻。

He liked the way I thought it through, applying evolutionary logic to anatomy.

他喜歡我把進化邏輯應用於解剖學的思考方式。

In medicine, whether you're being pimped in the OR or tackling a board question, being able to reason through unfamiliar territory often matters more than rote memorization.

在醫學界，無論你是在手術室裡被人 "拉皮條"，還是在應對董事會的問題，能夠在陌生的領域進行推理往往比死記硬背更重要。

They reason and apply critical thinking, and that shows up not just in rotations, but on exams too.

他們進行推理並運用批判性思維，這不僅體現在輪崗中，也體現在考試中。

What we're talking about is organizing knowledge in a hierarchical and interconnected way, starting with foundational concepts before focusing on the details.

我們所說的是以分層和相互關聯的方式組織知識，先從基礎概念開始，然後再關注細節。

No matter your views on Elon Musk himself, he popularized the concept of the semantic tree of learning, which provides a clear visual of what we're talking about here.

無論你對埃隆-馬斯克本人有什麼看法，他都普及了學習語義樹的概念，這為我們在這裡談論的內容提供了清晰的視覺效果。

The roots are the foundational concepts and basic building blocks that everything else grows from and builds upon.

根基是基礎概念和基本構件，其他一切都從根基上生長，並在此基礎上發展。

The trunk and major branches represent broader categories and are where key relationships emerge.

主幹和主要分支代表更廣泛的類別，也是出現關鍵關係的地方。

Smaller branches and leaves are the nuances, examples, and more specific details of what you're learning.

更小的枝葉是你所學知識的細微差別、實例和更具體的細節。

It's essential to master core concepts before memorizing the details.

在記憶細節之前，必須掌握核心概念。

If you seek understanding, memorization usually follows, apart from facts that have no specific reason behind them, such as an arbitrary date in history or the mass of an object.

如果你尋求理解，除了那些背後沒有具體原因的事實，如歷史上任意的日期或物體的品質，記憶通常會隨之而來。

You won't understand the value of those numbers, so in these cases, you will simply need to commit the facts to memory.

您不會理解這些數字的價值，是以在這種情況下，您只需將事實牢記於心。

But for most concepts, it's not just about memorizing the material, it's about understanding it on a deeper level.

但對於大多數概念來說，這不僅僅是背誦材料，而是要更深層次地理解它。

This enables you to understand the relationship between various components within a concept, so you're able to reason through tricky or unfamiliar questions on test day.

這使您能夠理解概念中各個組成部分之間的關係，從而在考試當天推理出棘手或不熟悉的問題。

What does the person who understands have over the memorizer?

They can answer questions correctly despite never encountering or studying them before.

儘管他們以前從未接觸過或學習過這些問題，但仍能正確回答。

They can reason their way through complexities and answer various versions of similar questions.

他們可以推理出複雜的問題，並回答類似問題的各種版本。

For example, take the equation of cardiac output, which is equal to heart rate times stroke volume.

例如，心輸出量等於心率乘以每搏量。

If you memorize the equation itself, you can plug in the numbers easily enough, but if you actually understand the equation, you can answer complex or unfamiliar questions.

如果你記住了等式本身，就可以輕鬆地輸入數字，但如果你真正理解了等式，就可以回答複雜或陌生的問題。

A 68-year-old male presents with shortness of breath on exertion.

一名 68 歲的男性在用力時出現氣短。

Physical exam reveals bilateral lower extremity edema and elevated jugular venous pressure.

體檢發現雙下肢水腫，頸靜脈壓升高。

Echocardiography shows impaired left ventricular contractility.

超聲心動圖顯示左心室收縮力受損。

Which of the following compensatory mechanisms is most likely to help maintain adequate cardiac output in this patient?

以下哪種代償機制最有可能幫助該患者維持足夠的心輸出量？

Decreased venous return A student who only memorized that cardiac output equals heart rate times stroke volume may be drawn to and tripped up by the keyword heart rate in answer choice B.

靜脈迴流減少 只記住心輸出量等於心率乘以每搏量的學生可能會被答案選項 B 中的關鍵詞心率所吸引和絆倒。

But a student who understands the physiologic meaning of stroke volume and how it's determined can apply deeper reasoning.

但是，如果學生理解了每搏容量的生理學含義以及如何確定每搏容量，就能進行更深入的推理。

Stroke volume is end-diastolic volume minus end-systolic volume.

每搏容積是舒張末期容積減去收縮末期容積。

With impaired left ventricular contractility, you'll get increased end-systolic volume, which means reduced stroke volume.

左心室收縮功能受損，收縮末期容積就會增加，這意味著每搏容積減少。

Therefore, cardiac output will drop unless some compensatory mechanism kicks in.

是以，除非某種代償機制發揮作用，否則心輸出量就會下降。

With A, increased afterload, it would make it harder to eject blood, which means it worsens the stroke volume and is not compensatory, so you can eliminate it.

如果是 A，後負荷增加，會使血液更難噴射，這意味著會使每搏量惡化，而不是代償性的，是以可以將其排除。

With option B, a decreased heart rate would reduce cardiac output, so this answer choice can be eliminated.

對於選項 B，心率降低會減少心輸出量，是以可以排除該答案選項。

With option C, increased end-diastolic volume leads to more preload.

對於選項 C，舒張末期容積增加會導致前負荷增加。

This can stretch the myocardium and enhance contractility via the Frank-Starling mechanism, which would help maintain cardiac output.

這可以拉伸心肌，並通過弗蘭克-斯塔林機制增強收縮力，從而有助於維持心輸出量。

This makes this option a strong contender.

這使得該方案成為強有力的競爭者。

And finally, with option D, decreased venous return results in less preload, which means less stroke volume, which would worsen the cardiac output.

最後，在選項 D 中，靜脈迴流減少會導致前負荷減少，這意味著每搏量減少，從而使心輸出量惡化。

是以，我們可以取消這一選項。

I remember a time in one of my senior year neuroscience upper division courses when memorization over understanding played out to the detriment of most of my classmates.

我記得在我高年級的一門神經科學高年級課程中，有一次背誦超過了理解，這對我的大多數同學都很不利。

My professor asked us if the delayed rectifier potassium channels, or KV, in a neuron had a significantly increased activation threshold, what would be the resulting effect on the shape and propagation of the action potential?

我的教授問我們，如果神經元中的延遲整流鉀通道（或 KV）的激活閾值顯著提高，會對動作電位的形狀和傳播產生什麼影響？

It was clearly a hypothetical question, and most of the class was stumped.

這顯然是一個假設性問題，全班大多數人都被難住了。

Because this wasn't a regurgitation question.

We were never directly taught this scenario, but it was testing whether we understood how the components of an action potential interact.

我們從未直接學習過這種情景，但這是在測試我們是否理解動作電位的組成部分是如何相互作用的。

KV channels are responsible for repolarizing the membrane after the depolarization spike.

KV 通道負責在去極化尖峰之後使膜恢復極化。

If those channels require a higher voltage threshold to open, they'll activate later, meaning repolarization is delayed.

如果這些通道需要更高的電壓閾值才能打開，它們就會晚一點激活，這意味著再極化會延遲。

That means the falling phase of the action potential is prolonged.

這意味著動作電位的下降階段會延長。

You'd see a broader, more drawn out waveform.

你會看到更寬廣、更拖沓的波形。

Also, the refractory period is extended, since the cell stays depolarized longer.

此外，由於細胞去極化的時間更長，是以折返期也會延長。

As a result, firing frequency decreases, and signal propagation down the axon slows.

是以，發射頻率會降低，信號沿軸突向下傳播的速度也會減慢。

I understood the dynamic interaction between sodium and potassium channels and how tweaking one variable changes the entire system.

我理解了鈉和鉀通道之間的動態相互作用，以及調整一個變量如何改變整個系統。

The overwhelming majority of my class missed that question.

我們班絕大多數同學都沒有回答這個問題。

It was only one other student and I who aced the test because we actually knew how to apply what we had learned, not what we had memorized.

只有我和另外一名學生通過了考試，因為我們知道如何運用所學知識，而不是死記硬背。

So how can you put this superpower into practice?

那麼，如何才能將這種超能力付諸實踐呢？

Don't just memorize, teach the concept to someone else.

不要只是死記硬背，要把概念教給別人。

This is also known as the Feynman technique.

By explaining a concept to someone else, you ensure you understand it inside and out.

通過向別人解釋一個概念，你可以確保自己從裡到外都理解了這個概念。

Consider how you would explain the concept to your grandmother or a child.

考慮如何向祖母或孩子解釋這一概念。

How could you simplify your explanation so that anyone could understand the concept regardless of their medical or scientific background?

如何簡化您的解釋，讓任何人，無論其醫學或科學背景如何，都能理解這一概念？

We even had a comment from a viewer once who said they practiced the Feynman technique by setting up their favorite stuffed animals to explain the complex concepts they were studying.

我們甚至曾經收到一位觀眾的評論，說他們通過擺放自己喜歡的毛絨玩具來解釋正在學習的複雜概念，以此來練習費曼技巧。

The magic of the Feynman technique is that as you try to explain a concept to someone else, you will naturally identify areas you were having difficulty explaining.

費曼技巧的神奇之處在於，當你嘗試向別人解釋一個概念時，你會自然而然地發現自己難以解釋的地方。