Students in the experiment read the explanations and completed their practice cases with feedback in the way outlined by their particular experimental condition (i.e., interleaved with one context, interleaved with two contexts, blocked with one context, blocked with two contexts).
Measuring Learning and Transfer
The students were then tested to see how much they could remember by answering multiple-choice and short-answer questions that assessed their knowledge about the concepts they learned.
Students were then given 15 transfer cases. These cases were clinical vignettes similar to those from the practice session. Students had to identify the physiological principle that applied, and provide an explanation for how the concept accounted for the clinical signs and symptoms presented in the vignette. Some of the transfer cases involved systems that were previously learned (e.g., fluid dynamics and respiratory disorders), or that were not previously learned (e.g., fluid dynamics and urinary tract cases).
Results
The researchers present a lot of data, but I summarize what I think are the main findings here.
First, the students answered about 70-80% of the knowledge questions, and performance did not depend on the experimental manipulations. So, at least for these questions, interleaving vs. blocking and context of examples didn’t really matter.
The results on the transfer cases are much more interesting. The students who learned with interleaving and two contexts had the highest scores on the near and far transfer cases. For the far transfer cases, having practice with two contexts was particularly important. There was no significant difference on the far transfer cases between the blocked and interleaved learning conditions as long as two contexts (i.e., two different organ systems) were used.
Conclusion
Overall, the results suggest that giving students practice with multiple contexts seems to be particularly important for far transfer, and when that happens, interleaving the examples is better than blocking.
The authors write about the importance of transfer for medical education, and specifically discuss transfer of premed knowledge to later clinical training (presumably undergraduate medical education, more casually referred to as medical school). But plenty of students take physiology for other reasons other than preparation for formal medical school. For example, in my department at Rhode Island College the behavioral health studies program students take physiological psychology and should be able to transfer the knowledge to their internship courses and work in mental health. And, these findings are in line with other research we have presented in other domains.
These findings make sense in light of the other research we have covered on our blog related to interleaving vs. blocking, and related to concrete examples and transfer of knowledge to other domains more generally. We know, for example, that using multiple concrete examples with different surface features is particularly helpful in helping students transfer the concept to other new examples (check out this blog: two examples are better than one). We also know that novices tend to focus on surface details more than experts (check out this blog: what do students remember from our examples?).
Essentially, multiple examples with different surface features is what the researchers did here for the two contexts conditions. When they gave students practice cases in two contexts, the underlying principle (e.g., fluid dynamics) was the same, but the surface features (e.g., respiratory system cases, cardiovascular system cases) were different. Thus, students in this condition were likely better able to clearly see the underlying principle and how it functioned in different contexts. This led to better performance applying the concept on their own in a third, new context (e.g., urinary tract cases).
