NP School · 6 min read · April 12, 2026
The most common piece of advice given to struggling NP students is to study more. Study harder. Put in more hours. This advice is well-intentioned and almost always wrong. The students who are struggling in NP school are rarely struggling because they are not putting in enough time. They are struggling because the time they are putting in is not being used effectively.
The research on learning and memory is unambiguous on this point: the methods most students use — re-reading, highlighting, reviewing notes — are among the least effective study strategies available. They feel productive because they are familiar and because they produce a sense of fluency (the feeling of recognizing information). But fluency is not the same as learning, and the sense of knowing something after re-reading it is not the same as being able to recall and apply it under exam conditions.
The most effective study strategy for NP school — and for board preparation — is active recall: the deliberate practice of retrieving information from memory rather than simply reviewing it. The research on active recall, summarized in books like Make It Stick (Brown, Roediger, and McDaniel, Harvard University Press, 2014), consistently shows that retrieval practice produces stronger, more durable learning than any form of passive review.
In practice, active recall means using practice questions, self-testing, and flashcards rather than re-reading. It means closing the book and trying to recall what you just learned before looking at it again. It means explaining concepts out loud, without notes, to test your own understanding. These methods are harder than passive review — they produce more errors, more uncertainty, and more discomfort. That discomfort is the signal that learning is happening.
"The difficulty of active recall is not a bug — it is the feature. The struggle to retrieve information is what makes the memory stick."
The second most important study principle for NP school is spaced repetition: reviewing content at increasing intervals over time rather than massing all review into a single session. The research on spaced repetition shows that content reviewed at spaced intervals is retained far better than content reviewed in a single massed session — even when the total study time is the same.
In practice, spaced repetition means building a study schedule that returns to previously learned content at regular intervals, rather than moving linearly through the curriculum and never revisiting earlier material. It means using tools — like the FNP Review's QBANK — that are designed to surface content at the intervals that maximize retention.