Rozenshtein Anna, Pearson Gregory D N, Yan Sherry X, Liu Andrew Z, Toy Dennis
Columbia University Medical Center, New York, New York.
Columbia University College of Physicians and Surgeons, New York, New York.
J Am Coll Radiol. 2016 Aug;13(8):979-84. doi: 10.1016/j.jacr.2016.03.031. Epub 2016 May 26.
Radiology instruction is based on the principle that grouped (or massed) repetition of an intellectual activity leads to expertise. The aim of this study was to test the hypothesis that the spaced (or interleaved) method of teaching chest x-ray interpretation is more effective than the massed method.
After institutional review board approval was obtained, 40 first- and second-year medical students were randomized into two groups matched by age, gender, and education experience. Both groups saw six examples of 12 common chest radiographic patterns, one grouped, the other scrambled randomly without repeating strings. After a distraction, participants took a multiple-choice test consisting of two cases in each radiographic pattern, one previously shown, one new. Results were analyzed using two-tailed Student's t test of proportion.
Comparing interleaved and massed groups, the average overall score was 57% versus 43% (P = .03), the recollection score was 61% versus 47% (P = .03), and the induction score was 53% versus 40% (P = 0.10), respectively. Comparing second- and first-year students, average scores were 67% and 39%, respectively (P < .01). First-year students in the interleaved and massed groups scored 55% and 36% (P = .02) in recall and 40% and 28% (P = .10) in induction. Second-year students in the interleaved and massed groups scored 71% and 63% (P = .36) in recall and 74% and 59% (P = .03) in induction.
The interleaved method of instruction leads to better results than the massed method across all levels of education. A higher level of medical education improves performance independent of method of instruction.
放射学教学基于这样一个原则，即对智力活动进行分组（或集中）重复可培养专业技能。本研究的目的是检验以下假设：间隔（或交错）式胸部X光解读教学方法比集中式教学方法更有效。
获得机构审查委员会批准后，40名一、二年级医学生被随机分为两组，根据年龄、性别和教育经历进行匹配。两组学生均观看了12种常见胸部X光片模式的6个示例，一组为集中展示，另一组为随机打乱顺序展示，不重复连续展示。经过一段时间的干扰后，参与者进行了多项选择题测试，每种X光片模式包含两个病例，一个是之前展示过的，一个是新的。结果采用双尾学生比例t检验进行分析。
比较交错式和集中式两组学生，平均总成绩分别为57%和43%（P = 0.03），回忆成绩分别为61%和47%（P = 0.03），归纳成绩分别为53%和40%（P = 0.10）。比较二年级和一年级学生，平均成绩分别为67%和39%（P < 0.01）。交错式和集中式组中的一年级学生在回忆方面的得分分别为55%和36%（P = 0.02），在归纳方面的得分分别为40%和28%（P = 0.10）。交错式和集中式组中的二年级学生在回忆方面的得分分别为71%和63%（P = 0.36），在归纳方面的得分分别为74%和59%（P = 0.03）。
在所有教育水平上，交错式教学方法比集中式教学方法产生的效果更好。较高水平的医学教育能提高成绩，且与教学方法无关。
