Why a question book?

Classically, test questions are used to measure learning, and the questions in this new book can certainly be used in this traditional manner, both by teachers and by students, and especially in combination with the companion textbook in this suite of educational products, Stahl’s Essential Psychopharmacology. That is, teachers may wish to test student learning following their lectures on these topics by utilizing these questions and answers as part of a final examination. Also, readers not taking a formal course may wish to quiz themselves after studying specific topics in the specific chapters of the textbook. The reader will also note that documentation of the answers to each question in this book refers the reader back to the specific section of the textbook where that answer can be found and explained in great detail; outside references for the answers to the questions in the book are also provided.

Do questions just document learning?

For the modern self-directed learner, questions do much more than just document learning; they can also provide beacons for what needs to be studied and the motivation for doing that even before you read a textbook. Thus, questions are also tools for prestudy self-assessment. If you want to know whether you have already mastered a certain area of psychopharmacology, you can ask yourself these self-assessment questions BEFORE you review any specific area in the field. Many reading a textbook of psychopharmacology are not novices but lifelong learners, and are likely to have areas of strength as well as areas of weakness. Getting correct answers will show you that a specific area is already well understood. On the other hand, getting lots of incorrect answers not only informs the self-motivated learner that a specific area needs further study, but can provide the motivation for that learner to fill in the gaps. Failure can be a powerful focuser for what to study and an energizing motivator for why to study.

“Adults don’t want answers to questions they have not asked”

The truth of this old saying is that taking a test AFTER study tends to feel like being forced to answer questions that the teacher has asked. However, modern readers with the mind-set of a self-directed learner want to focus on gaps in their knowledge, so looking at these same questions PRIOR to study is a way of asking the questions of yourself and thus owning them and their answers.

What is a “knowledge sandwich”?

Ideally, self-directed learners organize their study as a “knowledge sandwich” of meaty information lying between two slices of questions. The questions in this book can be the first slice of questioning, followed by consuming the “meat” of the subject material in any textbook, including Stahl’s Essential Psychopharmacology, or if you prefer, from a lecture, course, journal article, and the like. At the end of studying, another slice of testing shows whether learning has occurred, and whether performance has improved. You can utilize, for example, the continuing medical education (CME) tests that accompany Stahl’s Essential Psychopharmacology to test yourself after studying and document your learning (available at neiglobal.com). The rationale for this instructional design is also discussed in another one of our books, Best Practices in Medical Teaching, published in 2011. The self-assessment questions, additional “meaty” content on all the subject areas, plus post-tests are also available as the “Master Psychopharmacology Program” at neiglobal.com for those who prefer online learning rather than a textbook.

Is your learning unforgettable?

Finally, and perhaps most importantly, tests prevent forgetting. Thus, the self-assessment questions here actually create long-term remembering, and do not just document that initial learning has occurred. It is a sorry fact that learning that occurs following one exposure/reading of material is rapidly forgotten. We have discussed this in the accompanying book in this series, Best Practices in Medical Teaching. Perhaps 50% of what you learn after a single exposure to new, complex information is forgotten in 3–8 days, with some studies suggesting that little or nothing is remembered beyond 2 months! Exposing yourself to new material over time in bite-sized chunks and encountering the material again at a later time leads to more retention of information than does learning in a large bolus in a single setting, a concept sometimes called interval learning or spaced learning. Research has shown that when the re-exposure is done not as a review of the same material in the same manner, but as a test, retention is much enhanced. This results in the most efficient way of learning because the initial encoding (reading the material or hearing the lecture the first time) is consolidated for long-term retention much more effectively and completely if the re-exposure is in the form of questions. Thus, questions help you remember, and we hope that you utilize this book to maximize the efficiency of your learning to leverage the time you are able to put into your professional development.

How do you use this book?

To use this book, simply look on every right-hand page where you will see the question appear with a multiple choice format for the answer. Read the question, answer the question either in your head, on the page, or on another piece of paper. Then, turn the page; on the left side will appear not only the correct answer but also an explanation of why the correct answer is correct, why the incorrect answers are incorrect, and references that document the correct answers, both in the companion textbook, Stahl’s Essential Psychopharmacology, and elsewhere. The reader will also see at this time what peers who have already taken this test thought was the correct answer. While taking a test, the examinee is usually curious about how they are doing, how many peers get a question right, and, if the wrong answer was selected, how many peers also selected that answer wrongly. Such information can provide motivation, either as reinforcement for correct answers (yes!) or to drive the reader to understand the correct answer and never to feel the sting of missing that question again (ouch!). So, it is with the greatest wishes for your successful journey throughout psychiatry and psychopharmacology that I present this question book to you as one of the tools for your professional development, as well as for your fascination, learning, and remembering!

Stephen M. Stahl, MD, PhD

In memory of Daniel X. Freedman, mentor, colleague, and scientific father.