Educational psychology in medical learning: a randomised controlled trial of two aide memoires for the recall of causes of electromechanical dissociation

Objectives: Although mnemonics are commonly used in medical education there are few data on their effectiveness. A RCT was undertaken to test the hypothesis that a new aide memoire, “EMD-aide”, would be superior to the conventional “4Hs+4Ts” mnemonic in facilitating recall of causes of electromechanical dissociation (EMD) among house officers. Method: “EMD-aide”, organises causes of EMD by frequency of occurrence and ease of reversibility: four groups organised by shape, colour, position, numbering, clockwise sequence, and use of arrows. Eight hospitals were randomised in a controlled trial and 149 house officers were then recruited by telephone. Baseline ability to recall causes of EMD was recorded at one minute and overall. House officers were then sent a copy of either “4Hs+4Ts” or “EMD-aide” according to randomisation group. Recall ability was retested at one month. Results: 68 of 80 and 51 of 69 house officers completed the study in the “4Hs+4Ts” and “EMD-aide” groups respectively (NS) with similar baseline recall. After intervention median number of recalled causes was greater in the “EMD-aide” group, eight compared with seven at one minute (p = 0.034) and eight compared with seven overall, p = 0.067. Recall of all eight causes was more common in “EMD-aide” group, 54% compared with 35%, p = 0.054, and these house officers spent longer examining their aide memoire, p<0.001. Conclusions: “EMD-aide” may be superior to “4Hs+4Ts” in facilitating the recall of the causes of electromechanical dissociation. Educational psychology of medical learning and the use of aide memoires in general are worthy of further study.

[1]  M. Russell,et al.  The incidence of pulmonary embolism in unexplained sudden cardiac arrest with pulseless electrical activity. , 2000, The American journal of medicine.

[2]  M. Holzer,et al.  Pulmonary embolism as a cause of cardiac arrest: presentation and outcome. , 2000, Archives of internal medicine.

[3]  J. Calinas-Correia.  Recalling the causes of pulseless electrical activity (PEA) , 2000, Resuscitation.

[4]  G F Hayden,et al.  Alliteration in medicine: a puzzling profusion of p's , 1999, BMJ.

[5]  D. Goldhill,et al.  Physiological values and procedures in the 24 h before ICU admission from the ward , 1999, Anaesthesia.

[6]  D. Goldhill,et al.  Outcome of intensive care patients in a group of British intensive care units. , 1998, Critical care medicine.

[7]  P. McQuillan,et al.  Sequential recall of causes of electro-mechanical dissociation (EMD) , 1998, Resuscitation.

[8]  M. Oermann.  Evaluating critical thinking in clinical practice. , 1997, Nurse educator.

[9]  J. Ornato,et al.  The Universal ALS algorithm. An advisory statement by the Advanced Life Support Working Group of the International Liaison Committee on Resuscitation. , 1997, Resuscitation.

[10]  J. Beitz.  Unleashing the power of memory. The mighty mnemonic. , 1997, Nurse educator.

[11]  T. Scruggs,et al.  Remembering the Forgotten Art of Memory. , 1992 .

[12]  J. Camm,et al.  The management of electromechanical dissociation. , 1991, Resuscitation.

[13]  K. Higbee.  Some Motivational Aspects of Imagery Mnemonics , 1990 .

[14]  T. Aufderheide,et al.  Electromechanical dissociation: six years prehospital experience. , 1989, Resuscitation.

[15]  N. Cook,et al.  The applicability of verbal mnemonics for different populations: A review , 1989 .

[16]  Michael Pressley,et al.  Use of a mnemonic technique to teach young children foreign language vocabulary , 1981 .