Updated: Aug 19, 2019
The amount of information available us is astronomical. How do you keep it all organized? How do you stay current? Especially if you are a busy clinician. How do you find, review, and remember new research findings, or refresh what you already know?
Perhaps, like me, you're in private practice without institutional access to published research. Perhaps you do not have regularly-scheduled, built-in opportunities to review key info and add to your learning (like you might if you taught an assessment course and scheduled time to refresh the course content).
Most of us probably attend a conference or two per year, and take a couple of CE credits or workshops. That helps, but barely scratches the surface of what we need to do to stay current. There is just so much to keep up with!
This is a question I think a lot about. We have a strong ethical obligation to stay up-to-date. That means keeping up with the literature is an essential part of our job.
But it's a hard part of the job! It's a lot of work, without immediate reward. The payoff only comes later, when some piece of knowledge gives you insight for a complex case. Sometimes, it's easy to let this part of the job "slide" as you rush to finish the next report.
Because it's so hard and so easy to "let slide", I have developed a 5 Step Process I use to make sure I'm staying on track. There is nothing magical about these steps. You could have thought of them on your own, and may already be doing some these things.
However, having a specific set of steps helps us set, track, and meet goals. Goals for keeping up with new developments and reviewing what we already know. I review these steps every 6 months to help me commit to lifelong learning and see how well I'm keeping up.
Here are the 5 steps:
1. Plan to Learn - Put it on your schedule 2. Be Curious - Look up everything 3. Cultivate Sources - Let others bring ideas to you 4. Organize Information - Make some notes 5. Share - Bring ideas to others
Plan to Learn
The most important component of staying current is making time to stay current. Find ways to get this time on your schedule and hold yourself accountable. For example:
Schedule your learning time Block off time in your schedule each week to learn. Start with what time you have. Sometimes I only have 20-30 minutes during my lunch hour on testing days. While each session is short, this gets me 60-90 minutes of learning time a week, even during busy weeks. Over time, that adds up!
Find a project that will keep you accountable Having a reason you "have to" learn helps generate forward momentum. Your reason might be teaching a course at a local university. It might be supervising students. It could be writing a blog and committing to publishing something on a regular basis. It might be developing a passive income stream, like a book or e-course. It might be studying for a test, like the ABPP boards, or another specialty certification. It could be making handouts for your clients with info you find yourself sharing again and again. It might be refreshing the recommendations bank for your reports.
Find other people who will keep you accountable For many people, social obligations are incredibly motivating. If it motivates you to learn with others or to avoid "letting down" your peers, find a group or partner to motivate you. If you don't have a peer consultation group, find one, or start your own. If you don't have a supervisor or consultant, get one!
You know what's great? We've reached that point in our careers where we don't need to impress anyone anymore. We can admit, to ourselves at least, everything we don't know and everything we've been afraid to ask. No one will know what you Googled. No one will think you "should have" known something you didn't. So just look up everything. For example:
Google anything you don't know Any time you hear or read something you don't know, do a search right away. Or, write it in a notebook to search for later. The amount I don't know is staggering and humbling. But having a plan to look it up helps me feel better. I like to especially look up things I don't "really" know. For example, if I hear someone ask a question in a forum about the neurocognitive affects of anxiety and whether they're present when the person is on medication, I ask myself, "Uh... do I really know the answer to that?" If I can't think of the answer right away (and I usually can't!), it goes in the notebook.
Google anything you "know" but have forgotten There are lots of things I Google over and over. And over. Or sections of books I read and re-read. While this strategy is useful for reinforcing concepts, it can be a hard habit to get into. If you do child assessments for a living, I daresay learning and memorizing have always come easily. You may not have developed a habit of reviewing. But we know knowledge that doesn't get used decays. That means you have forgotten, well... a lot of info. Look it back up! If possible, relate the information to something new, like a new case you're thinking about. This technique (elaborative rehearsal) is especially linked to retention.
Psst.... you don't really have to Google I'm an introvert, so my usual information source is the internet. (Mostly I do PubMed searches.) But you can also get information lots of other ways. For extroverts - just ask people. There are forums, listservs, and blogs for clinicians who specialize in child assessment. (Feel free to email me for suggestions if for any reason you don't know about these options). If you prefer in person, start a peer consult group, or get individual consultation. You can also reach out to specialists in the field. They are often surprisingly willing to answer questions, or at least send you a reading list. If you don't know any specialists, reach out to anyone on one of those forums who gave an answer you liked. Ask them for help or a reading list. If you're more introverted but allergic to PubMed, the references section in the books on your shelf is a readily-available source of gems. If reading is not how you like to spend your downtime, try a podcast or take an online self-study course.
Make connections across different domains. Be curious even when you are doing something entirely unrelated to child assessment. Idly reading a "Dear Abby" column and a question comes up about how to help a child who is nervous about school? What do you really know about the current research on school refusal and how to treat it? Binge-watching Killing Eve on Amazon Prime? What do you really know about the current research on psychopathy and how it develops? Reading a fantastic book about beavers and how to get people to embrace the furry rodents as environmental partners? What do you remember about the science of decision-making or persuasion? This type of learning is especially useful. Making connections between different spheres of knowledge increases the likelihood you'll remember what you learned.
Cultivate Sources Pick a couple of easy, convenient, stimulating, and/or fun ways to find information easily. Maybe even make information come to you. For example:
Let others curate for you There are a lot of fantastic newsletters, podcasts, and email alerts you can sign up for. These will bring child-psychology-adjacent information right to your inbox! These might bring you direct knowledge, or spark some ideas for your next Google Search or Blog Post. Here are just a few I use: Podcasts: 99% Invisible with Roman Mars Hidden Brain with Shankar Vedantham Invisibilia from NPR The Testing Psychologist with Jeremy Sharp Newsletters: Barking Up the Wrong Tree by Eric Barker Brain Pickings by Maria Popova For the Interested by Josh Spector Blogs: Assessing Psyche (etc) by Joel Schneider Email Alerts: Frontiers article or topic alerts Science Daily content alerts Content alerts for journals like Child Development or the Journal of Child Psychology and Psychiatry
Embrace being a specialist. Maybe you don't have a lot of time to become a specialist (or, frankly, interest). If that's the case, embrace your limitations and go niche. Pick a subject area and do a PubMed search every once and a while for all new articles published in that area. (I got this tip from Deb Budding, author of Subcortical Structures and Cognition and the moderator of the Contemporary Brain-Behavior Relationships listserv. She provided consultation to me many years ago. When I asked how she stays current, she said she does a regular PubMed search for specific keywords, like "cerebellum"). You will quickly become more knowledgeable of research in that area than 90% of clinicians. Another option is to pick a prolific research group or network of researchers in your area. Follow those researchers intensely. Twitter makes a great resource for following specific researchers (especially in basic sciences like neuroanatomy). Scientists often tweet out their papers as soon as they are available (again, thanks to Dr. Budding for this tip!). PubMed searches by author will also work if you're not on Twitter.
Go general and pick topics at random If you prefer to be a generalist, go broad. Brainstorm a list of 25 topics and pick one at random to research every other week. Have everyone in your peer consult group suggest topics and cover these topics in a monthly journal club. Pick a researcher with a ton of publications. Over the course of a month, read any of her works you can find online. The more random your topics, the more likely you are to make unique connections between different subjects.
Refresh the basics A great way to refresh the basics is to read new textbooks that weren't available when you were in grad school. I know that sounds tedious and slow, but your background knowledge will actually make it a quick read. (Plus the info you didn't know will really stand out, almost as if printed in bold type.) If you wanted, you could easily knock out a textbook chapter in a week by in only 10 minutes a day. If possible, share texts with colleagues and buy used copies. (Otherwise this will get expensive.) Notice what papers the textbook author(s) felt were most relevant and useful about a topic. This will generate ideas for what original papers you will want to read. Or, you'll get ideas of specific researchers you want to follow.
Challenge yourself If the idea of reading yet another assessment textbook makes you feel stabby, try a "harder" book. That is, try a book where you don't have the same level of background knowledge. For example, try a book on functional neuroanatomy. Or try an in-depth dive into a particular disorder. Or try a treatise on a different approach to assessment. For example, try Subcortical Structures and Cognition: Implications for Neuropsychological Assessment by Len Koziol and Deb Budding for some functional neuroanatomy. Or What Causes ADHD by Joel Nigg for an in depth review of the research on a single disorder. Or Collaborative Therapeutic Neuropsychological Assessment by Tad Gorske and Steven Smith for a different approach to neuropsychological assessment. I like to read one challenging book a quarter.
Organize Your Information
The most difficult part of this plan for me is organizing all this info. I have whole file drawers stuffed with articles I've printed out that I intend to read "someday." I have no idea what articles are in there and no way to refer to them. It's chaos. A few months ago, I developed some plans for taming this chaos, at least a little bit.
Here's what I recommend:
Use an online information organization tool I like Evernote. Evernote lets you save articles (and other things, like pictures or your own notes). You can save articles in different "Notebooks", each of which could be a topic. You can also tag articles using your own tags. I use the tags to search through my entire online library of articles on a specific topic.
Use an old-fashioned notebook I have a journal I use as a commonplace book. I use it to jot down things like: concepts I want to look up later, ideas I want to pursue, blogposts I want to write, etc. I also write down 1 to 3 points about any article or newsletter I read or podcast I listen to. Picking out the salient points helps you think about "takeaways" you can actually use in your practice. Physically writing them down helps improve retention. Keeping the notes to just 1 to 3 points makes the notes easy to review.
Use the unpaywall extension. This isn't really an organizational idea, but it's a great tip I came across on the PED-NPSY listserv (h/t Tom Doda). If you don't have journal access, you know the frustration of an article being behind a paywall. Unpaywall is an extension for your browser. It searches for copies of an article that are available online somewhere. (E.g. on the author's university, personal, or ResearchGate website, or other repositories or open access resources). Unpaywall only accesses articles if it is legal. The way it works visually is: A little padlock icon shows up on the side of the page any time you search for an article. If the padlock is gray, there are no copies available online. If it's green, it's available and you can click through to the article.
Share Your Information
The best way to learn something is to teach it. Teaching something is also the most effective way to find gaps or "fuzziness" in your understanding! There is no better way to identify what you don't know about a topic - or what you have forgotten or failed to consider - than to try to share it with someone else. So make regular sharing of what you know a part of your routine. For example:
Write a blog This strategy is not for the faint of heart. You will spend way more time writing than you expected, and most blogs do not get many readers. If you keep a blog on your practice's website, it may increase your page's SEO, so there could be some benefit. It may also attract or convince people to book with you, as it gives them a little "taste" of what working with you is like. But the real benefit to blogging, in my opinion, is that it forces you to put your thought process in writing. In turn, that shows you what you don't know. Then you can go back and fill in those gaps. You might also search for other blog posts on the same topic for ideas, and end up stumbling across perspectives you never even considered. If you want to blog only occasionally, offer to "guest blog" for someone.
Answer questions on listservs or in Facebook groups This strategy also requires being brave. In these forums, you are talking to colleagues. You have to trust that you have valuable information, resources, ideas, or perspectives. At first, this requires a leap of faith. After the first few times, it is not so bad. If you keep it up, it actually starts building your confidence. You see that nothing "horrible" happens when you share your knowledge. You get to review a concept, and your peers get to learn from your info.
Give workshops This strategy is also for the courageous - those brave souls who are willing to engage in public speaking. Offer to speak with schools or parent groups. Volunteer to give a talk at your local professional society's meetings. Record a video of yourself talking about a subject you know well for your website. Offer to speak on a local podcast (or start hosting a podcast). If you'd rather not speak quite so publicly, consider using Help a Reporter Out (HARO). Through HARO, you can give an interview or blurb to an author writing about a topic you know a lot about.
Start working on a book This idea is in case speaking is not your thing and you want something more focused than a blog. Take advantage of your excellent writing skills and start on something bigger, like a book. Actually, it doesn't have to be a book. Maybe it's an e-course you're going to put together and sell on your website. Maybe it's a short book for your clients with resources and activities or exercises. Maybe it's 1-page handouts on topics you cover over and over again in feedbacks. Like "What is Dyslexia" or "What Does Anxiety Look Like in Children and Teens." Maybe it's a reading list of articles and books you would recommend in a content area where you're an expert. Maybe it's a booklet of ideas from colleagues, supervisors, and yourself about working with a specific population.
Supervise or Consult. Perhaps you have a touch of Impostor Syndrome. Maybe all these suggestions are making you think "I'm not enough of an expert to write a book or speak to a reporter." If that's the case, then you need to take even more drastic measures. Start offering consultation or supervision. Right now. The sooner you start getting paid for your expertise, the sooner you'll realize you already are an expert.
What strategies have you come up with?
Note: I edited this post in August to make it more readable and to add a few visuals. It is now written at the 5th grade reading level. There are 274 sentences (10.6 words per sentence). 17 of the sentences are hard to read. 7 of the sentences are very hard to read. There are 0 uses of the passive voice.