Teaching for understanding in medical classrooms using multimedia design principles

OBJECTIVES: In line with a recent report entitled Effective Use of Educational Technology in Medical Education from the Association of American Medical Colleges Institute for Improving Medical Education (AAMC-IME), this study examined whether revising a medical lecture based on evidence-based principles of multimedia design would lead to improved long-term transfer and retention in Year 3 medical students. A previous study yielded positive effects on an immediate retention test, but did not investigate long-term effects. METHODS: In a pre-test/post-test control design, a cohort of 37 Year 3 medical students at a private, midwestern medical school received a bullet point-based PowerPoint™ lecture on shock developed by the instructor as part of their core curriculum (the traditional condition group). Another cohort of 43 similar medical students received a lecture covering identical content using slides redesigned according to Mayer's evidence-based principles of multimedia design (the modified condition group). RESULTS: Findings showed that the modified condition group significantly outscored the traditional condition group on delayed tests of transfer given 1 week (d = 0.83) and 4 weeks (d = 1.17) after instruction, and on delayed tests of retention given 1 week (d = 0.83) and 4 weeks (d = 0.79) after instruction. The modified condition group also significantly outperformed the traditional condition group on immediate tests of retention (d = 1.49) and transfer (d = 0.76). CONCLUSIONS: This study provides the first evidence that applying multimedia design principles to an actual medical lecture has significant effects on measures of learner understanding (i.e. long-term transfer and long-term retention). This work reinforces the need to apply the science of learning and instruction in medical education.