VitalNotes

Paramedic Thinking. Essential Ideas. One Page at a Time.

Anki Setup & Use Guide

Introduction

Anki is a powerful, free flashcard program that helps you remember facts efficiently by using spaced repetition, a technique proven to enhance long-term retention. Whether you’re studying drugs, directives, anatomy, or pathophysiology, Anki turns passive study into active recall.

1. Installing Anki

Desktop (Recommended)

Mobile (Optional)

  • Android: Free on Google Play
  • iOS: Paid version in App Store (“AnkiMobile”)
  • Alternative: Use AnkiWeb via browser

Create AnkiWeb Account (for sync and backups)

2. How to Organize Your Decks

Create separate decks by topic or directive to keep things clean and focused.

Suggested Decks:

  • ALS Medical Directives
  • Pharmacology
  • Trauma & Procedures
  • Cardiology
  • Pathophysiology
  • Case Review & Scenarios

Subdecks can be created under major decks for specific areas (e.g., “ACS” under ALS).

3. Recommended Settings for Paramedic Students

These settings are optimized for short-, medium-, and long-term retention. Set them by clicking the gear icon next to a deck → Options.

When in doubt you can leave your settings to Default and change when you are more comfortable with the program.

New Card Learning Settings

SettingRecommended ValueWhy
New cards per day20–40Prevents overload and supports consistent learning
Learning steps (min)15 1440 4320Reinforces new info at 15 min, 1 day, and 3 days
Graduating interval7 daysFirst long-term recall after learning
Easy interval7 daysLonger interval if card feels easy
Starting ease250%Leave default; controls ease growth curve
OrderShow new cards in order addedHelps follow course sequence
Bury related new cardsEnabledAvoids seeing related cards back-to-back

Review (Mature Card) Settings

SettingRecommended ValueWhy
Maximum reviews/day100–200Balances review time with retention
Interval modifier100%Maintains default scheduling
Easy bonus130%Slight increase for easy-rated cards
Maximum interval36500 days (default)Leave as-is

Lapse Settings (Forgotten Cards)

SettingRecommended ValueWhy
Steps (in minutes)10 1440Relearn after 10 min and 1 day
New interval0%Resets interval to rebuild memory
Leech threshold8Identifies poor cards for rewrite
Leech actionTag OnlyHighlights but doesn’t suspend cards

Other Settings & Tips

SettingRecommendationWhy
Auto SyncEnabled (on open/close)Keeps progress backed up
Night ModeOptionalReduces eye strain
Graph View (Add-on)OptionalVisualizes review history
FSRS SchedulerNot recommended unless experiencedAdvanced users only

4. Creating Effective Flashcards

Basic Cards (Front → Back)

Use for simple Q&A: drug doses, vital ranges, definitions, etc.

Steps:

  1. Open Anki and click on the deck you want to add a card to.
  2. Click “Add” at the top of the screen.
  3. In the top-left dropdown menu (next to “Type”), make sure “Basic” is selected.
  4. Type your question in the “Front” field.
  5. Type the answer in the “Back” field.
  6. Click “Add” at the bottom of the window.

Cloze Cards (Fill-in-the-blank / Hidden Text)

Use for hiding key words or steps in a sentence, great for understanding and recall.

Steps:

  1. In Anki, click “Add.”
  2. From the “Type” dropdown, select “Cloze.”
  3. In the single text box (no Front/Back split), type a full sentence or phrase.
  4. Highlight the word(s) you want to hide and press Ctrl+Shift+C (or use the […] button).
    • It will format the hidden word like this: {{c1::your hidden word here}}
  5. You can add multiple clozes per card if needed ({{c2::…}}, etc.).
  6. Click “Add” to save.

Image Occlusion (Hide parts of an image)

Use for diagrams, charts, ECGs, protocol tables, anatomy, etc.

Steps to Create:

  1. Click “Add.”
  2. Change “Type” to “Image Occlusion.”
  3. Click “Add Image” and upload a diagram or screenshot (e.g., ALS PCS page, anatomy label).
  4. The image will open in an editor. Use your mouse to draw boxes over the parts you want to hide.
  5. When you’re done, click “Hide All, Guess One” (or “Hide One, Guess One”) at the bottom.
  6. Add a note if desired, then click “Create” and close.

Tips for Great Cards

  • Keep it one fact per card
  • Use simple, clear language
  • Avoid copying full paragraphs or lecture slides
  • Reference sources (e.g., ALS PCS, protocols)

5. Example Cards

Basic Card:

  • Front: What is the adult dose of ASA?
  • Back: 160–162 mg chewed and swallowed

Cloze Card:

  • Text: The contraindication to nitroglycerin is a systolic BP below {{c1::100 mmHg}}.

Image Occlusion:

  • Upload ECG or anatomy image, block out key elements, and prompt identification

6. Best Practices for Use

  • Review every day (5–20 mins is enough)
  • Don’t cram—trust the spacing algorithm
  • Add new cards immediately after class or study
  • Use tags to group by week, topic, or directive
  • Start a shared class deck to divide the work

7. Add-ons for Advanced Users (Optional)

To install: Tools > Add-ons > Get Add-ons

Useful Add-ons:

  • Image Occlusion Enhanced (great for ECGs, anatomy)
  • Hierarchical Tags (better organization)
  • Review Heatmap (visual progress tracker)
  • Advanced Browser (power user sorting and filters)

8. Using Anki for Exam and OSCE Prep

  • Create decks for each directive
  • Add cards for drug doses, contraindications, patch points, and procedures
  • Practice ECGs, conditions, and trauma decision-making using cloze and image cards
  • Use “Custom Study” to cram before exams if needed:
    • Click gear icon > Custom Study > “Review ahead” or “Increase new cards”

9. Backup, Sync, and Maintenance

  • Sync to AnkiWeb every day (automatically if enabled)
  • Export decks regularly for backup (File > Export)
  • Periodically run Tools > Check Database to keep Anki fast

10. Getting Started Today

  • Install Anki (desktop first)
  • Create a deck called “ALS Directives”
  • Add 3 cards based on today’s lecture
  • Study daily—even 10 minutes helps
  • Check back in 2 weeks and notice the improvement in your recall

Conclusion

Anki doesn’t work unless you do—but once you commit to daily use, it becomes one of the most powerful tools in your paramedic education arsenal. With a bit of setup and the right deck structure, you’ll build lasting memory on everything from cardiac protocols to obscure contraindications.

I. Learning Foundations

Build a strong system for thinking, studying, and remembering in high-pressure fields.

II. Practical Application

Move from theory to field-ready practice. These tools help bridge simulation, lab, and real calls.

  • Scenario Days – Make Learning Stick
    How to get more from scenario practice using repetition, debriefs, and learning loops. Turn repetition into retention.
  • Mastering Directive Decision-Making
    A breakdown of how to use directives in real-time, with pattern recognition, logic triggers, and threshold thinking.
  • Reflecting Without Journaling
    Not everyone journals—this guide offers quick, low-resistance alternatives to build metacognition through regular reflection.
  • Lab Integration Guide
    Use lab sessions to build decision-making habits, not just check off skills. Includes scenario prep, debriefing, and error capture.

III. Clinical Reasoning

Develop clarity under pressure. These pages train your diagnostic eye, pattern sense, and mental workflow.

IV. Resources

Your support tools: guides, summaries, templates, and setup walkthroughs.

  • Summary
    Recap of the big ideas behind VitalNotes: learn reflectively, study actively, and build a system that supports decision-making under pressure.
  • Helpful Resources
    Downloadables and quick-reference tools: directive cue sheets, Anki decks, debrief templates, and scenario aids.
  • Anki Setup & Use Guide
    Step-by-step instructions for downloading, customizing, and optimizing Anki for long-term retention.
  • Obsidian Setup & Use Guide
    How to build a clinical note vault in Obsidian: folder structures, templates, and linking strategies.
  • Sources and References
    A list of research and literature that supports the methods taught in the blog, with commentary on their application to clinical learning.