B-CLR

Learning the "Difficult Stuff": Multimedia Practices that Promote Effective Learning 

1. Coherence Principle: People learn better when extraneous words, pictures, and sounds are excluded rather than included.

2. Pre-Training Principle: People learn better from a multimedia lesson when they know the names and characteristics of the main concepts.

3. Spatial Contiguity Principle: Present corresponding words and pictures in close proximity to each other.

4. Temporal Contiguity Principle: Present corresponding words and pictures simultaneously rather than successively.

5. Signaling Principle: People learn better when the words include cues about the organization of the presentation.

6. Redundancy Principle: Pair animation and narration together without on-screen text.

7. Voice Principle: People learn better when words are spoken in a standard-accented human voice than in a machine voice or foreign-accented human voice.

8. Personalization Principle: People learn better when the words are in conversational style rather than formal style.

9. Segmenting Principle: Offer narrated animation in learner-paced segments rather than a continuous unit.

10. Modality Principle: Pair animation and narration together instead of pairing animation and on-screen text.

Thus, we see how the effective use of interactive multimedia as described by Rogers et al. (2002) can add clarity of information to a process through the offering of multiple "...representations of the same process (e.g., graph, a formula, a sound, a simulation)...."(p. 87); multimedia information can be "...displayed and interacted with in ways that make their relationship with each other more explicit to the learner..." (Rogers et al, 2002, p. 87).

Multimedia can also add richness and meaning to show as well as tell but if it is not done thoughtfully and with a real intent to practice these principles, it can add needless complexity and provoke learner frustration.

Free instructional design help is available to faculty redesigning their CHM courses for blended and online delivery. To find out more about B-CLR  consultation services, please contact  Geraud Plantegenest at plantege@msu.edu. You can also visit the B-CLR webpage at http://omerad.msu.edu/bclr/index.php

• Effective Use of Educational Technology in Medical Education. Colloquium on Educational Technology: Recommendations and Guidelines for Medical Educators. AAMC Institute for Improving Medical Education. 2007; 9-10.
• Mayer, R. E. (2001). Multimedia Learning. New York: Cambridge University Press.
• Preece J,Rogers Y & Sharp H. (2002) Interaction Design: Beyond Human-Computer Interaction. USA: Wiley & Sons.

Problem-based learning as an educational strategy has consistently been a point of debate among medical educators. While many educators recognize the implicit value of active learning in small groups, others are not convinced that PBL has lived up to expectations. 

Medical students generally recognize that PBL is more effective than large lecture classes in achieving a wide range of educational goals, such as:

• Making learning enjoyable
• Helping derive more accurate differential diagnoses
• Preparing for clerkships
• Enhancing learning skills that can be used for career-long learning
• Learning clinical problem-solving

One area where students are more anxious about PBL is as preparation for USMLE Step 1. The reasons are two-fold: this examination is a gateway that students must pass before moving to their clinical training, and many residency programs use USMLE Step 1 scores as part of their selection process. 

Figure 1 below summarizes the relationship between PBL exam scores and USMLE Step 1 scores (first try) for CHM students, aggregating data for graduates from 2001 through 2009. The data show a clear trend, with better PBL examination performance associated with higher USMLE Step 1 scores. The correlation between the two performance indicators is 0.79.  The pass score for USMLE Step 1 has increased over time and has been 182 or greater since 2001; currently it is 188. Although there is a consistent increase in board score performance associated with high PBL examination scores, the variability for each PBL performance cohort is reasonably consistent. This variability is indicative of the variety of factors involved in measures of academic performance. 

Please see the resources below for more information about PBL.

Albanese MA.  Problem-based learning: Why curricula are likely to show little effect on knowledge and clinical skills.  Medical Education. 2000; 34: 729-738.

Colliver JA. Effectiveness of problem-based learning curricula: Research and theory.  Academic Medicine. 2000; 75(3): 259-266.

Koh GCH, Khoo HE, Wong ML & Koh D.  The effects of problem-based learning during medical school on physician competency: A systematic review.  Canadian Medical Association Journal.  2008; 178(1): 34-41.

Van Berkel H & Schmidt H.  On the additional value of lectures in a problem-based learning curriculum. Education for Health. 2005; 18(1): 45-61.