Context-dependent Memory in a Meaningful Environment for Medical Education: in the Classroom and at the Bedside

Purpose: Learning-in-context is a much-discussed topic in medical education. Information is said to be better recalled when the learning environment resembles the later retrieval environment. Godden and Baddeley (1975) showed that divers recalled words better when the recall condition matched the original learning environment, i.e. underwater or on land. Though it is unclear whether the findings can be generalized for medical education, medical educators regularly refer to them. We replicated the Godden and Baddeley study in ecologically more valid conditions for medical education and extended it with meaningful subject matter (namely, a patient case description).

Method: Sixty-three clerks were randomized over four conditions, contrasting a clinical (bedside) with an educational (classroom) environment as both learning and recall conditions. Students were asked to recall a list of words and a patient case in the same environment or in the opposite environment as where they learned it.

Results: We failed to find a significant same-context advantage for free recall of the list of words and the patient case propositions. However, there does appear to be a slight tendency towards better recall of the case description when learning took place in the clinical environment.

Discussion: In medical education, the context, if conceived as physical surroundings, does not seem to contribute to a same-context advantage. One should be cautious in generalizing the findings of Godden and Baddeley. However, different forms of 'context' other than the physical one used in the Godden and Baddeley study may well enhance learning effects in medical education.