13 Strategies On How to Improve Reading Retention of Your Nursing School Textbook

If you’re reading this post then you’re probably already aware of the fact that while you’re in nursing school massive reading assignments are the norm. It’s not uncommon to be assigned a couple of hundred pages per test.

Ahhh! I feel like I’m reliving the anxiety just writing about it, anyways…

The idea of learning all of the information found in even a single chapter of a science textbook can leave even the best of students feeling overwhelmed. However, there are strategies that can be implemented to facilitate the learning process and increase comprehension.

“Bring on the tips”

Some of the strategies I’m going to share are ones that have been supported by research; others are ones that I used to get A’s through the nursing program I attended.


Part 1: Breaking Down the Reading Assignment

First off, let’s start with the reading assignment.  Okay, so this topic doesn’t directly have to do with how you read, but when you read. Retention takes time. Pulling an “all-nighter” may get you some right answers on the test the next day, but it’s not going to make you know the information or put it in your long term memory.

When it comes to doing the assigned reading, you need to spread it out… like butter. We want a smooth and consistent spread, not here a chunk, there a chunk. Although, everywhere a chunk, chunk, does start to sound slightly more appealing, it’s still not the preferred method of toast buttering by your palate.  For optimal digestion your reading needs to take place over time. To do this you have to know the time frame you’re dealing with. This means knowing exactly how many pages you have to read, and by what date.

This may sound obvious, but you’d be surprised how many people just consider chapters instead of looking ahead at pages. Then they get behind because they didn’t realize the last couple of chapters were the longest.

#1. Count the Number of Assigned Pages

Once you know how many pages you have to read, determine how long you have until your test. For the school that I went to schedules varied depending on the class and the semester. As a general rule though, I like to have everything read as soon as possible. For every 5 days of reading consider scheduling 2-3 days of review.

Simply completing the reading assignment will not get you an A. In fact, I couldn’t tell you how many times I’ve heard students say they read the material 2 or 3 times and still got a C.

With that in mind, don’t buy into the hype that “B’s are the new A’s”. That’s crap. A’s are, and always will be, the only A’s. If you want an A you can get it! You just have to be willing to put in the work and know how to work effectively. Reading is only the first step, review is where the real magic happens. But, in order to review effectively we first have to take in the information effectively. This comes down to basic time management skills and textbook reading techniques.

#2. Divide the Number of Pages By the Number of Weeks Until the Test. Leave Out Time For Review.

(# number of pages)/(# weeks until test – review) = pages per week

Now that you know how many pages you have to read per week, bust out that planner and determine when you are available to get it done.  If you’re a pre-nursing student, and don’t have much practice reading science texts, whatever amount of time you’re planning to schedule to do the reading, multiply that by at least 120%.  For time estimations, I’ll usually estimate to take an average of about 5 minutes per page.  Keep in mind this is a goal time estimation. I like to work under pressure. It’s not always realistic though. Some pages take 10 minutes, some take 2. It just depends on the content.

Once I know how many minutes, I convert it to hours, divide it by the days I have available, and voila! You have an estimation of how many hours per day you need to schedule to read the material. The key to this is not to cram all of your reading into one day.

More days is more better! Spread it like butter.

#3. Estimate How Long it Will Take You to Cover The Material.

(Number of pages per week) * (5 minutes per page) / (60 minutes per hour) = (hours per week)  (Hours per week) / (# days available) = estimation of time per day
Ex: (100 pages x 5 minutes per page)/ (60 minutes per hour) = 16.667 hrs            (16.667 hour per week) / (5 days available) = 3.33 hours or 3 hours and 20 min per reading day.


After determining how much time you’ll need to cover the required number of pages, it’s time to determine the order of how you’ll cover the information. I know what some of you are probably thinking:

“What do you mean, ‘the order’? Our teacher tells us when what topics are being lectured on.”

I also know that this goes against what most professionals recommend. Most “how to study” articles tell you to read what is to be lectured on before you get to class. I agree that this is ideal, but not a priority. I think it’s false reasoning to think that most learning occurs during lecture. I believe most learning occurs during review, where you personally verbalize what you have learned and “play” with the material.

One of the reason’s I was able to do so well through nursing school, other than actually doing the assigned reading, was that I read things out of order. There are probably a number of type A people out there whose toes are cringing at the idea, but hear me out.

Not all information is of equal importance! Let me put it in other terms: you know how celebrities are ranked as either A listers, or B listers, or etc, nursing concepts can be ranked similarly. You better know those A lister topics like the back of your hand, but its ok to forget the name of a D lister, as long as you can remember the role they played in that one movie.  I know it’s hard to believe that any teacher would be so cruel as to require you to learn material that wasn’t absolutely essential, but the fact remains, some concepts are more essential than others. Just because that C lister doesn’t come up in conversation often, doesn’t mean they aren’t important. When they show up on your nursing assignment they may be the star of the show.

For example: When studying pediatrics, do you think you should focus more time on Kawasaki disease or Type 1 diabetes?

We focus on Type 1 diabetes, of course! It’s a no brainer. Why? Because it’s more common, therefore the information is more useful, therefore the information is more important!

In an ideal world, all instructors would spend more time on the more important topics and present them earlier, but we live in the real world, and we know things aren’t always ideal. Instructors are people too. Sometimes the class gets off topic with questions, or maybe there was a story to be shared. For whatever reason, the most important topics aren’t always as heavily emphasized as they should be, and sometimes the most difficult concepts are presented right before the test.

If your instructor is particularly free spirited when it comes to covering lecture material, ask before planning out your schedule what topics they want you to focus on. Some teachers will be really nice about this and break it all down for you. Others will take this as you fishing for answers, and tell you everything is equally important. It’s not.

The best way I’ve found to determine what topics are most important is to ask myself how common they are and how lethal they are. More common and more lethal equal more important. However, fundamental concepts are always most important. These are the concepts that play a role in all conditions. For example: fluid and electrolyte imbalance, inflammatory response.

#4. Determine Which Topics Are Most Important, and Put Them At The Top

After establishing which topics are of most importance, adjust your list by moving complex topics towards the top. For instance, least important and least complex should be covered last, while most important and most complex should be covered first.  Again, ideally this would be how your lecture topics are already sequenced, but in my experience, there have been few occasions where I haven’t shuffled the reading assignment around.

#5. Determine Which Topics Are More Complex. More Complex and More Important Go At The Top

As a side note: steps 4 and 5 work best for information that does not need to be taught in a chronological order. In other words, if you’re working on something like math or chemistry, where concepts are built upon those previously introduced these steps may not be currently applicable to your situation, but they are something to keep in mind for future courses.

Congratulations!  You’ve completed part 1 of how to read a text book for increased comprehension. You now know what you will be focusing on, how long you have to focus on it, and what order the information will be mastered.

Now it’s time to discuss how to read your text.


Part 2: Reading the Text

To be an effective textbook reader you have to make a conscious effort to retain what you’re learning. Simply encountering information does not mean you’ve learned it. For example, how many times have you been looking for something, only to find it’s already in your hand? It sounds ridiculous, but let’s face it, it happens.

To read complex text and retain it you have got to focus on it! I highly recommend that you practice visualizing a web diagram.  At the center of the web is your main idea, related concepts branch off. The farther away from the center the more detailed the information. Visualization increases many people’s ability to retain information and is an important tool. I literally want you to close your eyes and see the topics. You can imagine written words, pictures, whatever works best, but see it.

#6. Understand the Big picture and Visualize it.

As an example, when reading a chapter on heart failure, your center should obviously consist of a patient with heart failure.  That part’s simple enough.  Now go through the chapter reading only the headings. These heading are the chunks of information you need to visualize branching off from your center focus. Pay attention to the color of the headings and the sizes. Often times in texts as information becomes more detailed the colors or the sizes of the headings (or both) will change, indicating a change in the level of depth.

#7. Read the Subject Headings Throughout The Chapter. Group Information Into Chunks. Direct Focus Based on Level of Importance

After getting an overview of the chapter by reading the headings you should have a good idea of how the information will be organized, and how you will be mentally grouping it.  You basically have a rough outline of your webbing.  As you begin to fill in the details of your webbing, remember to consider the significance of information. Not all information is of equal importance. Ask yourself “Why do I care?” or “Do I care?” about the information being presented. Relate information to familiar topics and ask yourself: “How is it similar?” or “How is it different?” Frequently texts contain information that is interesting to know, but not necessary. It’s ok to want to learn the details at the most in depth level (I encourage this), but make sure you have sufficient understanding of the core first.

Once you’ve established what information you do care about, and why you care about it, ask yourself simple questions about it.  Then as you read try to answer these questions.

In a study published in the Journal of Research in Science Teaching, subject’s comprehension of textbook reading was found to be significantly increased when they were asked simple questions every 150 words about what they had read, compared to the control group subjects who were not questioned.  Although this study was conducted in 2010, the strategy of using questions to increase one’s understanding of a subject actually predates Socrates.

Does the Socratic Method ring a bell?

This method has long been a standard in the instruction of medical students, used to bridge “the gap between textbooks and clinical care” according to an article published in the AMA Journal of Ethics.   So, to bridge the gap and increase comprehension, ask yourself questions.

#8. Ask Yourself Simple Questions About What You’re Reading

Summarizing as you read is also important. For each paragraph summarize in as simple of terms as possible using a short sentence. Then state how it relates to the paragraph above it. After reading all the paragraphs under a heading summarize again, and again state how that section relates to your center focus.  I know this sounds redundant, and it is, that’s the point. Repetition will get you that A I know you want.

#9. Summarize Each Paragraph. Summarize each section. Relate the Paragraphs to The Section, and The Section to The Center Focus

Lastly, read with the intention of teaching to a child. Keep in mind: children ask why, children don’t know big words, and children need things to be explained to them as simply as possible. Too often we trick ourselves into thinking we know something, only to find out when we are questioned on the topic that we don’t know it as well as we thought we did. This happens a lot with definitions of complex words. If you can’t break it down enough to explain it to a child, chances are you don’t really know what it means. If you can explain a subject in terms simple enough that a child can understand it, then you understand it. If you understand it, you are more likely to remember it, and there is a decreased need for rote memorization.

#10. Read With The Intention of Teaching

Part 3: Verbalize What You Have Read

Okay, so this part doesn’t exactly have to do with the actual reading of the text, but it’s important for retention and validating that you comprehend what you’ve read. You have to be able to say what you know! If you can’t say it or discuss it, you don’t actually know it.

#11. Review By Verbalizing

Get with a classmate and verbalize the mental web you’ve put together.  Start in the center and move out through the tears into deeper and deeper levels of detail. Remember all those simple summaries you did for each paragraph and topic? Bring them back to the fore front. Teach your classmate as if they were a small child. Keep it simple. Then, remember all those simple questions you asked yourself while reading? Test their knowledge by seeing if they can answer those questions correctly.

This is how I recommend spending a large portion of your review time before a test, but don’t wait until the test to start verbalizing what you’ve read! This should be a daily practice. Verbalize to yourself immediately after you’ve read (not necessarily out loud, but you can if you’d like). Imagine yourself teaching this information. Verbalize with someone else as much as possible, at least once or twice a week. Have them quiz you.

#12. Teach A Classmate

Have your classmate return the favor by verbalizing what they know, and then asking you questions about it. Remember, if you can’t verbalize it you don’t know it. I can’t stress enough how important the verbalization aspect of all this is. During testing situations you will not have notes to refer to.  In real life nursing situations you will have resources, but there is certain information patients expect you to know off the top of your head. When you can’t give them a quick answer to a simple question their confidence in your ability to care for them goes down.

#13. If You Can’t Verbalize It and Answer The Why Questions. You Don’t Know It Good Enough

That’s all for how to read a nursing text for more comprehension. I hope you enjoyed it and found it helpful.

Let me know what you think in the comments below. I’m excited to hear if these tactics helped improve anyone’s test scores.

Happy studying.




4 thoughts on “13 Strategies On How to Improve Reading Retention of Your Nursing School Textbook

  1. Christy B February 4, 2018 / 3:47 am

    Great tip to start with the most important topics 👍


    • rmlhealthandwellness February 4, 2018 / 5:36 pm

      Thanks Christy. I just know these are the strategies that really helped get me through. 🙂


  2. Vyvian Chacon April 4, 2018 / 9:03 am

    Hi, great tips for those studying nursing. These tips can also be modify for those studying other professions.


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