Adv Physiol Educ 32: 219 –224, 2008;
doi:10.1152/advan.00083.2007.
How We Teach
Learning scientific and medical terminology with a mnemonic strategy using
an illogical association technique
C. Jayne Brahler1 and Diane Walker2
1
University of Dayton, Department of Health and Sport Science, Dayton; and 2Miami Valley Career Technology Center,
Clayton, Ohio
Submitted 10 September 2007; accepted in final form 27 June 2008
Brahler CJ, Walker D. Learning scientific and medical terminology
with a mnemonic strategy using an illogical association technique. Adv
Physiol Educ 32: 219 –224, 2008; doi:10.1152/advan.00083.2007.—For
students pursuing careers in medical fields, knowledge of technical
and medical terminology is prerequisite to being able to solve problems in their respective disciplines and professions. The Dean Vaughn
Medical Terminology 350 Total Retention System, also known as
Medical Terminology 350 (25), is a mnemonic instructional and
learning strategy that combines mental imagery and keyword mnemonic elaboration processes to help students recall the scientific
meaning of Greek and Latin word parts. High school students in
Anatomy and Physiology classes at a career technology center were
divided into experimental (Medical Terminology 350), control (rote
memorization), or combination (Medical Terminology 350 and rote
memorization) groups and completed pre- and posttests of standardized word recall tests. Students in the Dean Vaughn Medical Terminology 350 Total Retention System group achieved significantly
greater pre- to posttest word recall improvement compared with
students in both the rote memorization (P ⱕ 0.0001) and combined
rote memorization and Medical Terminology 350 (P ⱕ 0.05) groups.
There appeared to be a dose-dependent response as the pre- to posttest
gain in word recall scores increased as exposure to the treatment
increased.
medical vocabulary; pedagogy; mental imagery
of higher-order, critical-thinking skills is an
important element of quality learning (3, 5), and the ability to
think critically is associated with increased academic (24),
professional (14), and daily living (11) successes. However,
critical thinking is a multifaceted learning process, and the
development of critical-thinking skills may require considerable time on the part of both students and instructors (26).
Numerous educational theories, models, and taxonomies
characterize the learning process and learning outcomes. Elaboration theory, for one, postulates that instruction should be
organized by increasing order of complexity to facilitate optimal learning (6, 14a, 18). Several educational models describe
the stages involved in the critical-thinking process and, in so
doing, elucidate the complexity of critical thought (9, 10, 13).
Bloom and Krathwohl (2) developed a taxonomy that categorizes learning outcomes into three interrelated and overlapping
learning domains: cognitive (knowledge), affective (attitude),
and psychomotor (skills). The cognitive domain emphasizes
intellectual outcomes and is divided into six levels that
progress from lower- to higher-order cognition. Those levels
are as follows: knowledge, comprehension, application, analysis, synthesis, and evaluation.
THE DEVELOPMENT
Address for reprint requests and other correspondence: C. J. Brahler, Univ.
of Dayton, Dept. of Health and Sport Science, Dayton, OH 45469 (e-mail:
brahler@udayton.edu).
In 2001, Anderson and Krathwohl revised Bloom’s original
taxonomy (Fig. 1). They divided the knowledge dimension into
factual knowledge, conceptual knowledge, procedural knowledge, and metacognition and created a matrix by adding a
cognitive process dimension. The cognitive process dimension
describes a hierarchy of processes used to learn such as
remembering, understanding, applying, analyzing, evaluating,
or creating.
The “factual” aspect of the knowledge dimension can include basic elements students must know to be acquainted with
a discipline but that also will be required to solve complex
problems in the discipline. The “remember” level of the cognitive process dimension includes such learning processes as
retrieving relevant knowledge from long-term memory such as
recalling the actions and side effects of a particular medication.
The lower-order knowledge and thinking processes can provide critical components for more complex, higher-order problem-solving and critical-thinking activities (8).
For students pursuing careers in medical fields, knowledge
of technical and medical terminology is prerequisite to being
able to solve problems in their respective careers and disciplines (8). A pedagogy that has the potential to facilitate
lower-order learning, such as memorization of medical terminology, may benefit educators and students by providing foundational knowledge that will be necessary for critical thinking
and problem solving. An additional benefit of facilitating the
memorization process is that valuable class time may be
redirected toward activities that promote higher-order thinking (4).
The Dean Vaughn Medical Terminology 350 Total Retention System, also known as Medical Terminology 350 (25), is
a learning system produced by DCM Instructional Systems to
facilitate the recall of factual information by linking new
material to an existing framework of life-long knowledge.
Specifically, it creates an association to a Greek or Latin
scientific word part by introducing a sound-alike keyword
(audionym) and related visual image that is familiar to the
learner but, however, unrelated to the medical term being
learned. The visual image is then altered “illogically” to link
the word part to its meaning. Medical Terminology 350 (25)
postulates that the “crazier” or “more illogical” an association,
the better it is to help recall, retain, and remember over a long
period of time and in essence “learn” the meanings of word
parts comprising medical terms.
Many cognitive psychologists, such as Reigeluth (18), agree
that it is imperative that learners elaborate on new information
to commit the new material to long-term memory. Elaboration
occurs when the learner constructs a memory link between a bit
of new information and some related information already held
in long-term memory (12). Ideally, the learner pauses for a
1043-4046/08 $8.00 Copyright © 2008 The American Physiological Society
219
How We Teach
220
LEARNING MEDICAL TERMINOLOGY WITH A MNEMONIC STRATEGY
Fig. 1. Bloom’s revised taxonomy.
moment and determines how to fit the new piece of information
into the existing framework. The elaboration process is complete when the learner successfully fits the new information
into their existing mental structures or schemata (22).
From a historical perspective, mnemonic strategies reach
back to ancient Greece. Mnemonics have been used for centuries to acquire and retain new bits of information. Simonides
of Ceos, a Greek lyric poet (circa 566-468 BCE), for instance,
used the ancient “method of loci,” a mnemonic strategy for
remembering and managing information. By placing mental
images into imagined places in one’s mind like a theatrical
backdrop, words and ideas were effectively remembered and
recalled (17).
More recently, mnemonics has proven to be a useful tool to
provide assistance to regular and special education students in
the process of committing ideas and vocabulary to memory
(16, 23). Mnemonics are thought to be effective because they
transform nonmeaningful, nonsensical, “crazy” information
into concrete, meaningful proxies (15).
The keyword method or strategy connects the new or unfamiliar information with what is already known by linking an
acoustically similar keyword phrase to the “unfamiliar” information to be learned. This strategy can be demonstrated using
the example of an acoustical cue such as the keyword “possum,” which sounds a lot like “posset.” “Posset” is defined as
a hot drink of spiced milk curdled with wine. To recall this
definition, the learner must employ the learning strategy by
picturing a possum having a hot drink, which in turn triggers
recall or retrieval of the answer (15). Another example of a
scientific term might be the term “palisade,” which acoustically
sounds like “palace.” “Palisade” means stake, so the learner
pictures a palace with stakes all around the walls of the palace.
This mental image cues the learner to recall that palisade
means stake. This illogical association links the unfamiliar
meaning to the familiar visual images and creates cognition (15).
Human thought is composed of autonomously created mental images. Our thoughts are framed in a structure of ordered
and sequenced pictures constructing a scrapbook in our minds.
Remembering is a process that retrieves that mental snapshot.
Mental imagery is a mnemonic learning strategy that enables
the student to expand upon new information by linking it to
mental pictures of their past. Classical orators, cognitive psychologists, and philosophers suggest that mental organization
structures itself in a spatial manner known as architectonics.
Architectonics links mental functioning and architecture by
imagining places or “loci” to form a network of order and
structure in which to store information or retain knowledge
(17). Creating pictures in our minds and labeling these images
is our natural storage system. These labels or terms comprise
the language of science. The process of learning science is
active and complex (20) with understanding formed at the
interface of terminology recall and conceptual constructs.
The purpose of this study was to test the effect of a
mnemonic learning strategy that uses illogical word associations (the Dean Vaughn Medical Terminology 350 Total Retention System) on recall of Greek and Latin word parts
constructing medical terminology compared with traditional
memorization techniques for high school students at a career
technology center in Dayton, OH.
METHODS
Written permission to conduct this study was provided by the
principal of the career technology center, high school division, in a
midwestern town in the United States (Dayton, OH). The Institutional
Fig. 2. The triangular pattern of mnemonic strategy.
Fig. 3. The linear pattern for rote memorization.
Advances in Physiology Education • VOL
32 • SEPTEMBER 2008
How We Teach
LEARNING MEDICAL TERMINOLOGY WITH A MNEMONIC STRATEGY
Table 1. Greek/Latin element pretest/posttest
Table 1.—Continued
Place the Meaning of the Greek/Latin Word Part in
the Space Provided Below
Element
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
gastrocardimegal-itis
dermatplastcerebrpath-ectomy
enter-osis
-otomy
adenangi-oma
nephrnephrarthrblephar-ologist
rhingingiv-malacia
-ology
spasm
-algia
craniendhemi-oid
hypercystcholehypo-scophyster-ostomy
para-lysis
cervicchondrcyanhem(at)ostpsycholipmylithophthalmoptproctcost-gram
acro-rhexis
carcin-penia
genbursoretr(o)tripstrept-desis
maniglosso-trophy
221
Place the Meaning of the Greek/Latin Word Part in
the Space Provided Below
Meaning
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81.
82.
83.
84.
85.
86.
87.
88.
89.
90.
91.
92.
93.
94.
95.
96.
97.
98.
99.
100.
Element
Meaning
supra-ptosis
dynmast-rrhaphy
dentcephalautoepihydrolobo-emesis
contraiasistransbrady-ectasis
cytodontleuk-esthesia
canthrostenocheil-cele
benign
semen
celioerythrovasomelancaudalinguamyringspondyl-
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
An element is defined as a Greek or Latin word part, either a prefix, root,
suffix, or combing form of medical term.
Continued
Review Board at the University of Dayton approved the use of the
data collected from the study under provision Code of Federal Regulations Title 45 Public Welfare, Department of Health and Human
Services Part 46 Protection of Human Subjects [45 CFR 46.101(b)
(4)]. Subjects were a convenience sample of senior Anatomy and
Physiology students who were enrolled in vocational programs including but not limited to Medical Secretary and Dental Assisting
programs.
The independent variable in this study was an audiovisual presentation that supplied an acoustical cue as a sound-alike name (audionym)
and a cartoon-like picture for the learner to create a mental image
coupling the keyword mnemonic and mental imagery elaboration
processes for each medical term word part. An example of a term
included in the study is the Greek word part “gastr-,” which means
stomach. “Gastr-” sounds a lot like “gas truck,” which cues the learner
to create the image of a gas truck in their “mind’s eye.” This image is
then changed to a “gas truck with a stomach for a tank” (25). The
learner connects the illogical image of a “gas truck with a stomach for
a tank” by the acoustical cue or sound-alike name for the Greek
element “gastr-.” This triangular mnemonic strategy is called the Dean
Vaughn Medical Terminology 350 Total Retention System (Fig. 2).
In contrast to the Dean Vaughn Medical Terminology 350 Total
Retention System strategy shown in Fig. 2, a linear pattern of rote
memorization is shown in Fig. 3.
There were three different groups of students in this study, namely,
an experimental or Dean Vaughn Medical Terminology 350 Total
Advances in Physiology Education • VOL
32 • SEPTEMBER 2008
How We Teach
222
LEARNING MEDICAL TERMINOLOGY WITH A MNEMONIC STRATEGY
Fig. 4. Student word bank cards.
Retention System group (n ⫽ 20), a control or rote memorization
group (n ⫽ 20), and a combination group who received both Dean
Vaughn Medical Terminology 350 Total Retention System and rote
memorization instruction (n ⫽ 11). The experimental group included
students from the Medical Secretary vocational program and students
from mixed vocational areas. The combination group contained students from the Dental Assisting vocational program and mixed vocational areas. The control group contained students from mixed vocational areas. All instruction occurred on 4 consecutive days during
regularly scheduled class sessions of 40-min periods. All students
were provided with 3 ⫻ 5-in. index cards, colored pencils, markers, a
single-hole punch, and a looseleaf collator ring for creating their study
materials.
Students in the Dean Vaughn Medical Terminology 350 Total
Retention System group viewed an audiovisual learning module (25)
consisting of 25 medical elements or word parts each class period for
4 consecutive days. Students were instructed “not to take notes” while
viewing the module presentation but to listen to the narrator for
the pronunciation of the Greek/Latin word part, the audionym, and the
meaning while creating a visual picture in their mind’s eye of the
associated Medical Terminology 350 image. Following the presentation, students in the experimental group were instructed to create word
bank cards that included the Greek or Latin element or word part, the
sound-alike name cue, a sketch of the cartoon-like picture to form the
mental image on the front of each index card, and the actual meaning
of the term on the back of each index card. After completing the first
25 elements, students viewed the next module consisting of 25 more
Greek and Latin elements of scientific terminology and created 25
additional word bank cards. This process was repeated until 100
elements had been presented and processed into 100 corresponding
word bank cards.
Students in the control or rote memorization group were presented
with the same 100 Greek or Latin elements, their meanings, and
examples of actual scientific terms. They were not provided the
acoustical cues or mental imagery supplied by the mnemonic strategy.
Similar to the Dean Vaughn Medical Terminology 350 Total Retention System group, the students in the control group were given 25
elements each day for 4 consecutive days along with the meaning and
examples of actual scientific terms and were instructed to make flash
cards with the element or word part and to place the actual meaning
of each term on the back of the card.
The “combination group” was composed of 11 students who
experienced everything the control group did during the experimental
period; however, they had viewed audiovisual modules from another
Dean Vaughn Total Retention System, Dental Terminology, in a
previous class. As such, these students had previous exposure to the
Dean Vaughn Total Retention System strategy and medical terminology associated with the practice of dentistry.
All students completed the same word recall pretest (Table 1) the
day before being presented with the first 25 terms and the same word
recall posttest (Table 1) at the end of the 9-wk term. The dependent
variable in this study was each student’s gain score, defined as the
pretest to posttest change in recall of the meanings of Greek and Latin
elements or word parts for the 100 scientific terms. ANOVA tests
were completed to determine if there was a statistically significant
difference in mean gain scores among the Dean Vaughn Medical
Terminology 350 Total Retention System, control, or combination
groups. Area of study/vocational program was identified as a potential
confounder and was statistically controlled by determining if there
was a statistically significant difference in gain scores between students in the medical secretary program, the dental assistant program,
and mixed vocational programs. ␣ was set at 0.05 (7).
Fig. 5. Mean gain from pretest to posttest for 3 groups of learners. * The mean
gain score is significantly greater for the Medical Terminology 350 group
compared with the combination (P ⱕ 0.05) or the rote memorization (P ⱕ
0.0001) groups.
Advances in Physiology Education • VOL
32 • SEPTEMBER 2008
How We Teach
LEARNING MEDICAL TERMINOLOGY WITH A MNEMONIC STRATEGY
RESULTS
The instructor observed that all of the students in the
experimental group created word bank cards illustrating the
Dean Vaughn Medical Terminology 350 Total Retention System process, and, although some students seemed skeptical of
the process initially, all of the students in the treatment group
enjoyed using this learning strategy because it made learning
fun. Examples of two student word bank cards are shown in
Fig. 4.
Mean gain scores were statistically significantly greater for
the Dean Vaughn Medical Terminology 350 Total Retention
System group compared with the control rote memorization
(P ⱕ 0.0001) and combination groups (P ⱕ 0.05), as shown in
Fig. 5. Mean gain scores were not statistically significantly
different between students in the medical secretary program,
the dental assistant program, and mixed vocational programs
(P ⱖ 0.05).
DISCUSSION
These results support earlier research that using mnemonic
strategies promotes effective recall of information such as
vocabulary and terminology (16, 17, 20). Students in the Dean
Vaughn Medical Terminology 350 Total Retention System
group demonstrated significantly greater recall of meanings of
Greek and Latin word parts using the triangular method of
coupling keyword and mental imagery learning strategies compared with linear memorization in the control group and the
combined linear memorization and mnemonic strategy group.
Interestingly, the word recall gain scores for the students in
the combination group, who had been exposed to part of the
treatment as a component of their dental vocational program,
were in between those of the control group and Dean Vaughn
Medical Terminology 350 Total Retention System group.
Although not measured in this study, the investigators observed that students using the Dean Vaughn Medical Terminology 350 Total Retention System are not only able to retain
the meanings of the Greek and Latin word parts over a longer
period of time compared with students who do not use the
strategy but also demonstrate a greater understanding of scientific text. Knowing the meanings of Greek and Latin word
parts at a glance allows for greater comprehension in cumbersome technical, medical, and scientific reading. Recalling the
word part “in context” increases the overall comprehension
because the learner does not have to pause to look up the
meaning of the word or skip over the “unknown term,” which
in turn increases the understanding of the reader, enhancing
their learning.
The Dean Vaughn Medical Terminology 350 Total Retention System appears to be equally effective in the postsecondary setting. The current investigators have found Medical
Terminology 350 to be very effective for instructing Pharmacy
Technicians, Phlebotomy Technicians, Medical Assistants, and
Medical Secretary students at the Miami Valley Career Technology Center (Adult Education Division) in Clayton, OH.
Additionally, Medical Terminology 350 was very effective for
instructing adult English as a Second Language (ESL) students
from the former Soviet Union as paramedical professionals
speaking Russian and Lithuanian languages implemented
Medical Terminology 350 to learn medical terms and English
scientific vocabulary to enter the United States workforce.
223
The Dean Vaughn Medical Terminology 350 Total Retention System learning strategies appear to transfer to other
learning situations as students reported they had successfully
used the Dean Vaughn Total Retention System mnemonic
strategy in other classes. They were reportedly able to recognize prefix, root, and suffix word parts and to know the
meaning of complex vocabulary and terminology at a glance
within the context of their reading. Students reported, “Although crazy, it works!” In fact, the crazier or less logical the
association, the easier it was to recall, remember, and in
essence “learn” the meanings of scientific terms without using
a dictionary to look up each medical term by identifying the
parts that comprise that word.
In summary, this study tested the effect of illogical word
associations on the recall of Greek and Latin word roots
comprising scientific terminology. The findings suggest that
the “illogical association” illustrated by the Dean Vaughn
Medical Terminology 350 Total Retention System process is
an effective way to facilitate and improve the recall process
because this tool effectively links the new material into an
existing framework of knowledge and familiar associations.
REFERENCES
1. Anderson LW, Krathwohl DR. (editors). A Taxonomy for Learning,
Reaching and Assessing: a Revision of Bloom’s Taxonomy of Educational
Objectives (complete edition). New York: Longman, 2007.
2. Bloom BS, Krathwohl DR. Taxonomy of Educational Objectives: the Classification of Educational Goals, by a Committee of College and University
Examiners. Handbook 1: Cognitive Domain. New York: Longman, 1956.
3. Brahler CJ, Peterson NS, Johnson EC. Developing on-line learning materials for higher education: an overview of current education. Educ Technol
Soc 2: 1999; http://www.ifets.info/journals/2_2/jayne_brahler.html.
4. Brahler CJ, Quitadamo IJ, Johnson EC. Student critical thinking is
enhanced by developing exercise prescription plans using online learning
modules. Adv Physiol Educ 26: 210 –221, 2002.
5. Browne MN, Keeley SM. Do college students know how to “think
critically” when they graduate? Res Serv Teach 1: 2–3, 1988.
6. Chanlin L. The effects of verbal elaboration and visual elaboration on
student learning. Int J Instr Media 24: 333, 1997.
7. Creswell J. Research Design: Qualitative and Quantitative Approaches.
Thousand Oaks, CA: Sage, 1994, p. 132–133.
8. Duan Y. Selecting and applying taxonomies for learning outcomes: a nursing
example. Int J Nursing Educ Schol 3: 2005; http://www.bepress.com/ijnes/
vol3/iss1/art10.
9. Facione PA, Facione NC. Are College Students Disposed to Think?
Millbrae, CA: California Academic, 1994.
10. Garrison DR. Critical thinking and self-directed learning in adult education: an analysis of responsibility and control issues. Adult Educ Quart 42:
136 –148, 1992.
11. Gibbs G, Jenkins A. Teaching Large Classes in Higher Education.
London: Kogan Page, 1992.
12. Grier L, Ratner H. Elaboration: the role of activity and conceptual
processing in children’s memory. Child Study J 26: 229 –252, 1996.
13. Henri F. Computer Conferencing and Content Analysis. Heidelberg:
Springer-Verlag, 1991.
14. Holmes J, Clizbe E. Facing the 21st century. Business Educ Forum 52:
33–35, 1997.
14a.Learning Theories. Learning-Theories.com. Knowledge Base and Webliography. Elaboration Theory (Reigeluth). http://www.learning-theories.com/
elaboration-theory-reigeluth.html [15 May 2008].
15. Mastropieri M, Scruggs T. Enhancing school success with mnemonic
strategies. Intervent School Clinic 33: 201, 1998.
16. Mastropieri M, Sweda J. Putting mnemonic strategies to work in an
inclusive classroom. Learn Disabilities Res Pract 15: 69, 2000.
17. Parker R. The architectonics of memory: on built form and built thought.
Leonardo 30: 147, 1997.
18. Reigeluth CM. (editor). Instructional Theories and Models: an Overview
of Their Current Status. Hillsdale, NJ: Erlbaum, 1983.
Advances in Physiology Education • VOL
32 • SEPTEMBER 2008
How We Teach
224
LEARNING MEDICAL TERMINOLOGY WITH A MNEMONIC STRATEGY
20. Ridgeway V, Dunston P. Content determines process: seeing the familiar
in new ways. Read Writ Quart 16: 119, 2000.
21. Ritchie D, Karge B. Making information memorable: enhanced knowledge retention and recall through the elaboration process. Prevent School
Fail 41: 21–33, 1996.
22. Schunk D. Learning Theories (review edition). Englewood Cliffs, NJ:
Prentice-Hall, 1996.
23. Stephens J, Dwyer F. Effect of varied mnemonics strategies in facilitating
student achievement of different educational objectives. Int J Instr Media
24: 75, 1997.
24. Steward RJ, Al-Abdulla Y. An Examination of the Relationship Between
Critical Thinking and Academic Success on a University Campus. Lawrence, KS: Univ. of Kansas, 1989 (ERIC no. ED318936).
25. Vaughn D. Medical Terminology 350. Westwood: DCM Systems, 2004,
p. 107–123.
26. Way WL, Nitzke SA. Design and assessment of critical thinking instruction in nutrition. In: Family and Consumer Sciences Teacher: Yearbook
18. Inquiry Into Thinking, edited by Thomas RG, Laster JF. Alexandria,
VA: American Association for Family and Consumer Sciences, 1998,
p. 211–226.
Advances in Physiology Education • VOL
32 • SEPTEMBER 2008