Learning during simulation training is prone to retroactive interference

摘要

Context Retroactive interference occurs when newly acquired information inhibits recall of previously learned information. This has been shown to influence recall of sounds, tastes and word associations, and is typically seen when learners receive training on one area of content and are then exposed to new content before being evaluated on the original content. Thus far, retroactive interference has received little attention in medical education and has not been studied during simulation training. Our objective was to evaluate whether retroactive interference occurs during simulation training. Methods We randomised 167 Year 1 medical students to one of two training protocols. After training on a cardiac murmur, participants were tested either on the same cardiac murmur followed by a novel murmur (the non-interference protocol), or on the novel murmur followed by the training murmur (the interference protocol). We evaluated performance on both murmurs at 1hour and 6weeks post-training. Results We found a significant interaction between training protocol and diagnostic performance on training versus novel murmurs at both testing time-points. Students in the non-interference protocol had increased odds of achieving success on the training murmur relative to the novel murmur at 1hour (odds ratio [OR] 4.96; p<0.001) and at 6weeks (OR 4.23; p=0.001) after training. By comparison, students in the interference protocol did not demonstrate improved performance on the training murmur relative to the novel murmur at either evaluation (1hour post-training: OR 0.56 [p=0.08]; 6weeks post-training: OR 0.66 [p=0.23]). Conclusions Consistent with the theory of retroactive interference, students who encountered a novel murmur between training and evaluation on the murmur on which they had been trained showed no improvement in diagnostic performance following simulation training. These findings should serve to warn educators to consider retroactive interference when designing simulation training sessions.