Abstract
In this article, the contributions of cognitive psychology to research and development of medical education are assessed. The cognitive psychology of learning consists of activation of prior knowledge while processing new information and elaboration on the resulting new knowledge to facilitate storing in long-term memory. This process is limited by the size of working memory. Six interventions based on cognitive theory that facilitate learning and expertise development are discussed: (1) Fostering self-explanation, (2) elaborative discussion, and (3) distributed practice; (4) help with decreasing cognitive load, (5) promoting retrieval practice, and (6) supporting interleaving practice. These interventions contribute in different measure to various instructional methods in use in medical education: problem-based learning, team-based learning, worked examples, mixed practice, serial-cue presentation, and deliberate reflection. The article concludes that systematic research into the applicability of these ideas to the practice of medical education presently is limited and should be intensified.
Highlights
Research into medical education began to attract serious attention with the publication of the Journal of Medical Education ( Academic Medicine) in 1951
First we present a crash course in the cognitive psychology of knowledge acquisition
Team-based learning (TBL) consists of three phases: (i) A preparatory phase, in which students study individually preassigned materials often conveyed through video; (ii) an in-class readiness assurance phase, consisting of an individual test, a subsequent retest taken after discussion of the answers to the individual test are discussed in a team, and teacher feedback; (iii) an in-class application phase in which students through facilitated interteam discussion solve new problems and answer new questions derived from the initial learning materials
Summary
Research into medical education began to attract serious attention with the publication of the Journal of Medical Education ( Academic Medicine) in 1951. We will focus here on how cognitive conceptualizations of learning and instruction have assisted in an understanding of knowledge acquisition and expertise development in medicine. When first-year medical students are confronted with information new to them from a chapter of Guyton and Hall’s textbook of medical physiology, they activate prior knowledge from high-school or college biology to help them interpret the new information; they use existing knowledge to construct new knowledge This new understanding, if sufficient thorough, is stored in long-term memory to be used for subsequent learning or application (Anderson et al 2017). A third and final process is systems consolidation in which memories are moved from the hippocampal area to the cortex and become indestructible— not necessarily retrievable (Winocur and Moscovitch 2011). Retrievability is influenced by the extent to which students apply their knowledge in contexts of sufficient variability and the extent to which these contexts resemble the context in which it was learned initially (Eva et al 1998; Norman 2009)
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