Council on Medical Student Education in Pediatrics


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It's ok to make things "difficult" for your students: test them, space out learning, and mix it up. Recent Research on Human Learning Challenges Conventional Instructional Strategies. Roher D et al. Educational Researcher 2010(39):406-412.

Reviewed by Martin Pusic, with thanks to John Andrews for suggesting this article

What is the focus of this paper?
Rohrer and Pashler are two cognitive psychologists who care about the basic science of learning. Over the years, they have done a large number of experimental trials in general education looking at questions of how people best learn factual material.

What are the three main messages of this paper?
First, testing, hour for hour, can be a better way of learning than extra studying! Testing makes us actively engage in the material in a way that studying cannot. At the most basic level, they quote a study where simply changing the chapter summary format from: "All preganglionic axons release Acetylcholine" to "All preganglionic axons release _______" resulted in demonstrable improvements in learning.

Second, the authors point out spacing between boluses of instruction is an important instructional element for two reasons: a) it implies that we plan to intentionally repeat and re-bolus important material and b) it requires students to focus on retention and not just immediate recall.

Third, "interleaving" is an educational term that we would do well to incorporate into our medical education lexicon. Nice tidy curricula where we learn everything about the respiratory system before going on to circulation are examples of blocked instruction. Rohrer and Pashler point out that this design works well for immediate post-test scores but, compared with "interleaved" (or mixed) practice, is not nearly as effective for application of the knowledge in the messy, mixed up world.

The review concludes with an exploration of why these basic principles are not as widely adopted as one might have hoped.

Editor's note: The concept of "interleaving" is well documented in the technical skill literature in which blocked practice is more effective than random practice for immediate test results, but the later is much better for long-term retention of the skill. If you have feedback about the Journal Club, please contact ____________________. (SLB)

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