Using insights from cognitive science for the teaching of clinical skills: AMEE Guide No. 155

Figures & data

Table 1. Order of the strategy with the most evidence, and a description of what to do, why it is important, and how to do in ALS.

Strategies	What to do	Why it is important	How to do
Spacing effect	Distribute the learning sessions with longer time intervals between sessions.	Allow participants to forget part of their declarative knowledge to avoid the Illusion of Knowing and to increase retention.	Instead of having training over a single -day, training can be spread over several days. In every training session, the key concepts of previous sessions can be repeated.
Testing effect	Test (both theory and skill) the participants at different times.	Increase retention and identify gaps in understanding, while integrating declarative and procedural knowledge.	At the beginning of every training session, add a test that integrates all the learning components.
Feedback	Provide guided feedback during study/training sessions and after tests.	Help learners identify what they do not know and avoid the proceduralization of incorrect knowledge.	Provide different types of feedback, while decreasing the amount of feedback as learners progress, until they are able to perform without feedback.
Interleaving	Instead of training in blocks, integrate all different aspects in a single training session	Support learners to contrast different information. Create an interval between studying/practicing the same content/skill	Instead of having blocks of training such as ABCDE and Rhythm Recognition, integrate them all together in different sessions.
Overlearning	In the last part of the training, learners should practice more than ‘getting right’. They should practice beyond proficiency.	Allow the learner to increase the probability of choosing the appropriate procedural knowledge, consolidating the skills to long-term memory	In the last day of training, conduct multiple simulated scenarios. If there are mistakes, the overlearning session should be moved forward.
Generation and elaboration	Allows participants to attend a simulated scenario in which ALS is necessary	Support learners to activate related declarative and procedural knowledge	At the beginning of training, participants should attend a simulated scenario

Figure 1. On the left side is a training design of an introduction to ALS course using evidence based cognitive science strategies. On the right side is the traditional design of the same course.