Effects of learning content in context on knowledge acquisition and recall: a pretest-posttest control group design.

Esther M Bergman,Anique B H De Bruin,Cees P M Van Der Vleuten,Jan G M Kooloos,Jimmie Leppink,Marc A T M Vorstenbosch,Ghita C W M Puts,Albert J J A Scherpbier

doi:10.1186/s12909-015-0416-0

Abstract

BackgroundIt is generally assumed that learning in context increases performance. This study investigates the relationship between the characteristics of a paper-patient context (relevance and familiarity), the mechanisms through which the cognitive dimension of context could improve learning (activation of prior knowledge, elaboration and increasing retrieval cues), and test performance.MethodsA total of 145 medical students completed a pretest of 40 questions, of which half were with a patient vignette. One week later, they studied musculoskeletal anatomy in the dissection room without a paper-patient context (control group) or with (ir)relevant-(un)familiar context (experimental groups), and completed a cognitive load scale. Following a short delay, the students completed a posttest.ResultsSurprisingly, our results show that students who studied in context did not perform better than students who studied without context. This finding may be explained by an interaction of the participants’ expertise level, the nature of anatomical knowledge and students’ approaches to learning. A relevant-familiar context only reduced the negative effect of learning the content in context. Our results suggest discouraging the introduction of an uncommon disease to illustrate a basic science concept. Higher self-perceived learning scores predict higher performance. Interestingly, students performed significantly better on the questions with context in both tests, possibly due to a ‘framing effect’.ConclusionsSince studies focusing on the physical and affective dimensions of context have also failed to find a positive influence of learning in a clinically relevant context, further research seems necessary to refine our theories around the role of context in learning.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0416-0) contains supplementary material, which is available to authorized users.

Highlights

It is generally assumed that learning in context increases performance
This study aims to contribute to the literature on learning in context by investigating whether and how a paper-patient case used as context in basic science education can influence the acquisition and recall of knowledge
This study aims to contribute to the literature on teaching in context by investigating whether and how a paper-patient used as a context during learning of a basic science can influence acquisition and recall of knowledge

Summary

Introduction

It is generally assumed that learning in context increases performance. This study investigates the relationship between the characteristics of a paper-patient context (relevance and familiarity), the mechanisms through which the cognitive dimension of context could improve learning (activation of prior knowledge, elaboration and increasing retrieval cues), and test performance. Extensive research on the physical dimension (for a review see Smith and Vela [8]), has pointed towards a ‘same-context advantage’, explained by the idea that cues present in the environment during learning are encoded in the memory along with the content. When these cues reappear in the environment in which the content is recalled, they facilitate retrieval of the content [9]

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