Context dependent memory in two learning environments: the tutorial room and the operating theatre

Increasingly, medical education has focused on moving away from tutorial and lecture based learning to more clinical teaching environments. Such a strategy poses significant logistical challenges in an era of increasing student numbers. While intuitively better, it is difficult to find evidence that empirically supports this change. Much of this is based on the belief that what is taught in a given environment is best recalled in that same environment. We tested this hypothesis using a free recall experimental model. Fourteen volunteers were taught pre-recorded audio lists of thirty words in two learning environments, a tutorial room and an operating theatre. They then recalled the words in either the original environment or at the alternative site. In the operating theatre participants wore full theatre attire and gathered around an operating table while learning and recalling words. In the tutorial room, participants wore causal clothes and were seated around a table while performing the same exercises. The same time duration (fifteen minutes) and disruption was experienced by all participants between learning and recalling, regardless of the environments used, thus excluding differences in recall due to disruption. The fourteen volunteers consisted of male and female medical undergraduates fluent in English. The mean recall score from the twenty eight tests performed in the same environment as the learning episode was 12.96 +/- 4.63 (SD). The mean recall score from the twenty eight tests performed in an alternative environment to the learning episode was 13.5 +/- 5.31(SD), indicating that changing the recall environment from the learning environment does not cause any statistical difference (p=0.4447). This supports the continued use of tutorials, lectures and videos for training in settings remote from the clinical environment, thus demonstrating that such an approach is both practical and effective, and ultimately facilitates the expansion of medical student numbers without compromising effectiveness.