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Cognitive Stuffing Quiz Acknowledgement Marcel D’Eon, BSc (Hons), MEd, PhD University of Saskatchewan Some studies of medical students’ long-term recall of simple knowledge in the basic sciences have shown that they retain about __% by the end of school, forgetting ___% within 2 weeks. Retain: a. 20% b. 30% c. 40% d. 50% e. 60% Forget a. 5% b. 15% c. 25% d. 35% e. 45% • Basic science, medical school • Custers EJFM, ten Cate OTJ. Very long-term retention of basic science knowledge in doctors after graduation. Med Educ 2011. 45:422-430. – Lost 25% within 2 weeks (down to 75%) – Retain 40% at end of school – Retain 25-30% until ~25 years A study at the UMN CVM gave students the same exam 15 months after taking the urinary systems exam. The mean knowledge loss on those questions was A. 5% B. 10% C. 20% D. 30% E. 35% • 30% loss for routine lectures • 18% loss for team-based learning class – Malone E, Speith A. Team-based learning in a subsection of a veterinary course as compared to standard lectures. J SoTL 2012. 12(3):88-107 A study evaluating methods of teaching veterinary dermatology at Oregon State. Initial test scores (immediately after lecture) were ~80%. After 1-2 months, student scores were A. 45% B. 55% C. 65% D. 75% E. NSD • 54-55% – No difference with or without clickers – Students more focused on the test right after class vs the use of clickers – Plant JD. Incorporating an audience response system into veterinary dermatology lectures: Effect on student knowledge retention and satisfaction. JVME 2007. 34(5):674-677. What we put in doesn’t stay knowledge 100 90 80 Amount of material 70 60 50 40 30 20 10 0 teach immediate 2 weeks 1 year 4 years post grad later Do they remember the important stuff? Which subject usually suffers the most knowledge loss in medical students? A. Immunology B. Neuroanatomy C. Physiology Knowledge loss after 1 year Immunology – 17.6% Neuroanatomy – 52% Physiology- 19.4% Overall -25% Not related to performance on first exam Limited review and spaced practice? One study evaluated graduating medical students knowledge of neuroanatomy. They took the same test as they did first year. As first years, the average score was 82%. What was it in their final year? A. 33% B. 46% C. 58% D. 70% • 33% • Only 2 students would have passed the test • No correlation between course satisfaction and retention • Mateen FJ, D’Eon MF. Neuroanatomy: a single institution study of knowledge loss. Med Teach 2008. 30:537-539. A study of anatomical knowledge 21 months later : Unreinforced information questions changed from 69% accuracy to ___ accuracy? A. 39% B. 49% C. 59 % D. 79% A study of anatomical knowledge 21 months later : Reinforced clinical questions changed from 50% accuracy to ___ % accuracy? A. 46% B. 56% C. 66% D. 76% • 12 mo -> 21 mo • Unreinforced information – 69% -> 59% • Reinforced (clinical) information – 50% -> 56% – Blunt MJ, Blizard PJ. Recall and retrieval of anatomical knowledge. Br J Med Educ 1975 9:255-263. 1. Knowledge doesn’t stick without repetition Based upon a classic study, assimilation of lecture information by students begins to diminish after how many minutes? A. 10 B. 15 C. 20 D. 25 E. 30 Stuart J, Rutherford RJD Medical student concentration during lectures The Lancet, 1978 While teachers are lecturing, students are paying attention what percentage of the time? A. 30 B. 40 C. 50 D. 60 E. >75 50% (1984 study) Students recorded items in their notes concerning ___% of material given in a 15minute lecture, a 30-minute lecture, and in a 45minute lecture. A. 41, 25, 20 B. 50, 39, 31 C. 75, 52, 40 D. 82, 60, 50 E. 89, 74, 60 • J McLeish, 1960’s study • Reported in Penner, 1984. Why Many College Teachers Cannot Lecture Wrote notes on 41% of material if first 15 min 25% of material in a 30 min set 20% of material in a 45 min set In today’s social media environment, the assimilation curve is shifted: A. to the left (assimilation diminishes earlier) B. minimally C. to the right (assimilation diminishes later) Use of Technological Distractions During an Average Lecture 0.6 0.5 % of Quadrants 0.4 0.3 0.2 0.1 0 0 10 20 30 Time Point (minutes) 40 50 60 Not distracted by technology 0.9 0.8 0.7 % of quadrants 0.6 0.5 0.4 0.3 0.2 0.1 0 0 10 20 30 40 50 60 2. Attention spans are limited Need to get their attention Repeat the important stuff To learn all the terms and relationships expected of medical students in a 1st year physiology course in 2000, how many had to be learned per hour of contact time? A. 3 B. 6 C. 9 D. 12 E. 15 To learn all the terms and concepts expected of medical students in a cardiovascular systems course in 2000, how many needed to be learned per hour of contact time? A. 3 B. 6 C. 9 D. 12 E. 15 • D’Eon – test data, averaged over 3 years – 15 topics/basic sci on test – 12 topics/clinical on test • Lectures – Estimated 24 concepts/hour preclinical courses – Estimated 13 concepts/hour clinical courses – 1984 • Russell IJ, Hendricson WD, Herbert RJ. Effects of lecture information density on medical student achievement. J Med Educ 1984. 59: 881-889. A recommended rate of learning of new facts or concepts per hour at university level is: A. 3 B. 6 C. 9 D. 12 E. 15 • 4 items +/- 1 – Cowan N. The magical number 4 in short –term memory: a reconsideration of mental storage capacity. Behav Brain Sci 2000. 24:87-185. • 2 seconds of verbal information • Can focus on 1 item at a time A medical school study looked at material from different time points in the class to determine what type of learning inhibition was likely present. They found that students did best on the material from which part of class? A. First 15 min B. Second 15 min C. Third 15 min D. Final 15 min • Final 15 min – “retroactive inhibition” – Later material displaced earlier material – Russell IJ, Hendricson, WD, Herbert RJ. Effects of lecture information density on medical student achievement. J Med Educ 1984. 59: 881889. We have to let go of some stuff! 3. Presentation order and summaries are important One study of knowledge growth in medical students found that pretest items marked “Don’t Know” were correctly answered 65% of the time on the posttest. What percent of pretest items marked incorrectly were answered correctly on the posttest? A. 10% B. 20% C. 35% D. 50% E. 70% • “Don’t know” – Incorrect pretest -> 65% correct posttest • “I think I know” – Incorrect pretest -> 35% correct posttest 4. Previous knowledge gets in the way Summary 1. Repetition is necessary Summary 2. Plan on a limited attention span Summary 3. 3-5 main points – Important stuff at the end! Summary • 4. Uncover misconceptions