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