Koens Franciska, Ten Cate Olle Th J, Custers Eugène J F M
University Medical Center Utrecht, School of Medical Sciences, Onderwijsinstituut, Stratenum 0.303, P.O. Box 85060, 3508 AB Utrecht, The Netherlands.
Adv Health Sci Educ Theory Pract. 2003;8(2):155-65. doi: 10.1023/a:1024993619713.
Learning-in-context is a much-discussed topic in medical education. Information is said to be better recalled when the learning environment resembles the later retrieval environment. Godden and Baddeley (1975) showed that divers recalled words better when the recall condition matched the original learning environment, i.e. underwater or on land. Though it is unclear whether the findings can be generalized for medical education, medical educators regularly refer to them. We replicated the Godden and Baddeley study in ecologically more valid conditions for medical education and extended it with meaningful subject matter (namely, a patient case description).
Sixty-three clerks were randomized over four conditions, contrasting a clinical (bedside) with an educational (classroom) environment as both learning and recall conditions. Students were asked to recall a list of words and a patient case in the same environment or in the opposite environment as where they learned it.
We failed to find a significant same-context advantage for free recall of the list of words and the patient case propositions. However, there does appear to be a slight tendency towards better recall of the case description when learning took place in the clinical environment.
In medical education, the context, if conceived as physical surroundings, does not seem to contribute to a same-context advantage. One should be cautious in generalizing the findings of Godden and Baddeley. However, different forms of 'context' other than the physical one used in the Godden and Baddeley study may well enhance learning effects in medical education.
情境学习是医学教育中一个备受讨论的话题。据说当学习环境与后期检索环境相似时,信息的记忆效果会更好。戈登和巴德利(1975年)表明,潜水员在回忆单词时,如果回忆条件与最初的学习环境相匹配,即在水下或陆地上,效果会更好。尽管尚不清楚这些研究结果是否能推广到医学教育中,但医学教育工作者经常提及。我们在对医学教育而言生态效度更高的条件下重复了戈登和巴德利的研究,并以有意义的主题内容(即一个患者病例描述)对其进行了扩展。
63名实习生被随机分配到四种条件下,将临床(床边)环境与教育(教室)环境作为学习和回忆条件进行对比。要求学生在与学习环境相同或相反的环境中回忆一组单词和一个患者病例。
我们未能发现对于单词列表和患者病例命题的自由回忆存在显著的同情境优势。然而,当在临床环境中进行学习时,确实似乎存在对病例描述回忆更好的轻微趋势。
在医学教育中,如果将情境理解为物理环境,似乎并不会带来同情境优势。在推广戈登和巴德利的研究结果时应谨慎。然而,除了戈登和巴德利研究中使用的物理情境之外,其他不同形式的“情境”很可能会增强医学教育中的学习效果。