Study Plans · 5 min read · April 25, 2026
Most students study in blocks: they spend a study session on cardiovascular content, then a session on respiratory content, then a session on endocrine content. This approach — called "blocked practice" — feels efficient and organized. The content is grouped logically, the session has a clear focus, and the student finishes feeling like they have mastered the material.
The research on learning suggests that this feeling of mastery is partly illusory — and that a different approach, called "interleaving," produces better long-term retention and better exam performance, despite feeling less efficient.
Interleaving is the practice of mixing different content areas or problem types within a single study session, rather than blocking them by category. Instead of spending an entire session on cardiovascular content, an interleaved session might alternate between cardiovascular, respiratory, endocrine, and psychiatric questions — mixing content areas in a way that feels less organized but produces better learning.
The research on interleaving consistently shows that it produces better long-term retention and better transfer — the ability to apply knowledge in new contexts — than blocked practice. A landmark study by Kornell and Bjork (2008) found that students who studied with interleaved examples performed significantly better on a subsequent test than students who studied with blocked examples, even though the interleaved students rated their learning as less effective during the study session.
"Interleaving is one of the most powerful and least intuitive study strategies. It feels less efficient, but it produces better learning — because it requires the kind of discrimination and comparison that real-world application demands." — Kornell and Bjork, Journal of Experimental Psychology, 2008
The board exam is inherently interleaved — questions from different content areas appear in random order, requiring you to identify the relevant content area and apply the appropriate clinical reasoning for each question. Students who have practiced exclusively in blocks are less prepared for this interleaved format than students who have practiced with mixed content.
Interleaving also builds the discrimination skills that board questions require: the ability to distinguish between similar presentations, to recognize which clinical framework applies to a given scenario, and to avoid the pattern-matching errors that come from seeing only one type of question at a time.