Effect of Massed Versus Interleaved Teaching Method on Performance of Students in Radiology
Abstract
Purpose 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.Methods 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.Results 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.Conclusions 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.
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In Rozenshtein et al. (2016), interleaved practice enabled participants to better distinguish and recognise differences in patterns than blocked practice.
“Interleaved practice enabled participants to better distinguish and recognise differences in patterns than blocked practice, which supported the discriminative-contrast hypothesis.”
From Spacing and Interleaving Effects Require Distinct Theoretical Bases: a Systematic Review Testing the Cognitive Load and Discriminative-Contrast Hypotheses (2021) · cites this paper as Rozenshtein et al. (2016)
Cites
(1994) · The MIT Press eBooks · doi:10.7551/mitpress/4561.001.0001 · Cited by 1,741 · see citing works
The serial position effect of free recall.
Murdock, B. B. (1962) · Journal of Experimental Psychology · doi:10.1037/h0045106 · Cited by 1,717 · see citing works
Metacognition: Knowing about Knowing
Allen, B. (1995) · Information Processing & Management · doi:10.1016/0306-4573(95)80050-4 · Cited by 877 · see citing works
Learning Concepts and Categories: Is Spacing the “Enemy of Induction”?
Kornell, N., & Bjork, R. A. (2008) · Psychological Science · doi:10.1111/j.1467-9280.2008.02127.x · Cited by 602 · see citing works
Component-levels theory of the effects of spacing of repetitions on recall and recognition
Glenberg, A. M. (1979) · Memory & Cognition · doi:10.3758/bf03197590 · Cited by 444 · see citing works
Training ‘greeble’ experts: a framework for studying expert object recognition processes
Gauthier, L., Williams, P., Tarr, M. J., & Tanaka, J. (1998) · Vision Research · doi:10.1016/s0042-6989(97)00442-2 · Cited by 401 · see citing works
The shuffling of mathematics problems improves learning
Rohrer, D., & Taylor, K. (2007) · Instructional Science · doi:10.1007/s11251-007-9015-8 · Cited by 357 · see citing works
Maintenance of Foreign Language Vocabulary and the Spacing Effect
Bahrick, H. P., Bahrick, L. E., Bahrick, A. S., & Bahrick, P. E. (1993) · Psychological Science · doi:10.1111/j.1467-9280.1993.tb00571.x · Cited by 334 · see citing works
Application of the testing and spacing effects to name learning
Carpenter, S. K., & DeLosh, E. L. (2005) · Applied Cognitive Psychology · doi:10.1002/acp.1101 · Cited by 270 · see citing works
Parallel brain systems for learning with and without awareness.Preprint
Reber, P. J., & Squire, L. R. (1994) · Learning & Memory · doi:10.1101/lm.1.4.217 · Cited by 266 · see citing works
Bloom, K. C., & Shuell, T. J. (1981) · The Journal of Educational Research · doi:10.1080/00220671.1981.10885317 · Cited by 243 · see citing works
Encapsulation of Implicit and Explicit Memory in Sequence Learning
Reber, P. J., & Squire, L. R. (1998) · Journal of Cognitive Neuroscience · doi:10.1162/089892998562681 · Cited by 209 · see citing works
The Training and Transfer of Real-World Perceptual Expertise
Tanaka, J. W., Curran, T., & Sheinberg, D. L. (2005) · Psychological Science · doi:10.1111/j.0956-7976.2005.00795.x · Cited by 176 · see citing works
Concepts do more than categorize
Solomon, K. O., Medin, D. L., & Lynch, E. B. (1999) · Trends in Cognitive Sciences · doi:10.1016/s1364-6613(99)01288-7 · Cited by 152 · see citing works
Contextual Enrichment and Distribution of Practice in the Classroom
Smith, S. M., & Rothkopf, E. Z. (1984) · Cognition and Instruction · doi:10.1207/s1532690xci0103_4 · Cited by 133 · see citing works
Effects of repetition and spaced review upon retention of a complex learning task.
Reynolds, J. H., & Glaser, R. A. (1964) · Journal of Educational Psychology · doi:10.1037/h0040734 · Cited by 123 · see citing works
Information‐processing analysis of college teaching
Bjork, R. A. (1979) · Educational Psychologist · doi:10.1080/00461527909529203 · Cited by 62 · see citing works
Learning 'How' Versus Learning 'When': Improving Transfer of Problem-Solving Principles
VanderStoep, S. W., & Seifert, C. M. (1994) · Journal of the Learning Sciences · doi:10.1207/s15327809jls0301_3 · Cited by 45 · see citing works
The effect of spaced practice on explicit and implicit memory
Perruchet, P. (1989) · British Journal of Psychology · doi:10.1111/j.2044-8295.1989.tb02306.x · Cited by 42 · see citing works
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Conceptualising spaced learning in health professions education: A scoping review
Versteeg, M., Hendriks, R. A., Thomas, A., Ommering, B. W. C., & Steendijk, P. (2020) · Medical Education · doi:10.1111/medu.14025 · Cited by 107 · see citing works
Chen, O., Paas, F., & Sweller, J. (2021) · Educational Psychology Review · doi:10.1007/s10648-021-09613-w · Cited by 62 · see citing works
- Authors
- Rozenshtein, A., Pearson, G. D. N., Yan, S. X., Liu, A. Z., & Toy, D.
- Affiliations
- Columbia University Irving Medical Center (US)
- Columbia University (US)
- Yale University (US)
- Corresponding author
- Yan, Sherry X.
- Venue
- Journal of the American College of Radiology
- Publisher
- Elsevier BV
- Published
- 2016-08
- Volume
- 13
- Issue
- 8
- Pages
- 979-984
- ISSN
- 1546-1440 (ISSN-L)
- OpenAlex
- W2405975714
- Cited by
- 53
- References
- 19
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 19 · 2023: 7 · 2022: 6 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 2
- FWCI
- 1.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American College of Radiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- interleaving, massed practice, spaced repetition, chest X-ray interpretation, radiology education, medical students, memory retrieval, induction
- MeSH terms
- Adult, Educational Measurement, Female, Humans, Male, New York, Pattern Recognition, Visual, Radiology, Mental Recall, Students, Medical, Task Performance and Analysis, Teaching, Radiography, Thoracic, Young Adult
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