Edgar Dale's Pyramid of Learning in medical education: Further expansion of the myth

INTRODUCTION: A mythical Pyramid of Learning, usually attributed to Edgar Dale (or the National Training Laboratories NTL) and giving student learning retention rates, has been cited in a wide range of educational literature. A 2013 literature review indicated that medical education literature similarly cites this Pyramid. It was hoped that highlighting this myth in that review would reduce references to the Pyramid in future medical education literature. This study aimed at determining what change in Pyramid citation has occurred in the past 5 years. METHODS: A documented literature review, following the same process as the original review, was conducted. The search dates were September 2012 to April 2018, and the databases were Academic Search Complete, CINAHL, Medline and Google Scholar. Sources were from peer-reviewed journals or conferences, in English. RESULTS: From an initial search result of 992 documents, 41 were found to match the criteria. Trends discovered are: the number of Pyramid citations in medical education literature is increasing dramatically, new sources of the Pyramid are now being used, refutations of the Pyramid are being used to support it, and even researchers who acknowledge the weakness of the Pyramid still cite it. DISCUSSION AND CONCLUSION: In spite of the 2013 review, the situation has become worse. One possible reason is that refutations use too polite academic wording, and other researchers then consider the Pyramid to be merely "disputed" or "debated." To kill the myth of the Pyramid, it is necessary for this article's Abstract to state unequivocally: The Pyramid is rubbish, the statistics are rubbish, and they do not come from Edgar Dale. Until the NTL can provide details about the original research, their version must also be treated as rubbish.