Desirable Difficulty: Theory and application of intentionally challenging learning

CONTEXT

Health professions trainees must acquire a vast amount of clinical knowledge and skills, and a deliberate instructional design approach is needed to provide trainees with effective learning strategies. One powerful yet counterintuitive strategy that facilitates long-term learning is incorporating intentional difficulties during the learning process. Difficulties that require more effort from learners may impede short-term learning but are ultimately beneficial for long-term learning and are therefore termed Desirable Difficulties.

OBJECTIVES

In this cross-cutting edge paper, we describe the Desirable Difficulty effect from three theoretical perspectives originating in different fields, discuss common evidence-based Desirable Difficulty strategies used in Health Professions Education and explore emerging research that could further optimise Desirable Difficulty-enhanced learning for health professions trainees.

METHODS

We synthesise theory and research from psychology, cognitive science and Health Professions Education literatures to further the understanding and application of Desirable Difficulties. We introduce three theoretical perspectives that provide a comprehensive overview of the theoretical underpinnings of the Desirable Difficulty effect: the New Theory of Disuse, the Challenge Point Framework and Cognitive Load Theory. We then illustrate how three common Desirable Difficulty strategies in medical education research-retrieval practice, spaced practice and interleaved practice-can be understood through these theoretical lenses. Finally, we provide relevant examples from the literature and explore emerging research in this area.

CONCLUSIONS

This paper summarises the theory and empirical research on Desirable Difficulties during the learning process, from explaining what they are and why they may be effective to how they have been applied in different contexts. We argue that providing educators and trainees with a comprehensive theoretical and applied understanding of Desirable Difficulty will promote deliberate instructional design decisions and lead to more effective learning.

Effects of active engagement and spaced retrieval practice on knowledge and application of a self-assessment rubric

PURPOSE/OBJECTIVES

This study examined effects of active engagement (ENG) and spaced retrieval practice (SRP) on D1 dental students' self-assessment knowledge acquisition.

METHODS

D1 dental students (N = 120) were randomly assigned to one of four conditions in a 2 (ENG or no ENG) X 2 (SRP or no SRP) design. Students were tested on their knowledge of a self-assessment grading rubric (on a 30-item multiple-choice exam) and their ability to apply the rubric (on a simulated dentoform assessment).

RESULTS

There were significant main effects of both ENG and SRP on both outcome measures. Both ENG and SRP increased students' knowledge of, and ability to apply, the self-assessment rubric. Effects of ENG were larger than those of SRP. There was also a significant ENG X SRP interaction on the knowledge measure. The effect of SRP was larger in the no-ENG conditions than the ENG conditions, which may reflect a ceiling effect in the ENG conditions.

CONCLUSIONS

ENG and SRP have the potential to substantially enhance D1 dental students' learning outcomes. These results should motivate dental educators to reject outdated instructional techniques and thereby unleash students' full learning potential. Additional research is needed with a wider range of dental students and learner topics.

How and Why Do Students Use Learning Strategies? A Mixed Methods Study on Learning Strategies and Desirable Difficulties With Effective Strategy Users

In order to ensure long-term retention of information students must move from relying on surface-level approaches that are seemingly effective in the short-term to “building in” so called “desirable difficulties,” with the aim of achieving understanding and long-term retention of the subject matter. But how can this level of self-regulation be achieved by students when learning? Traditionally, research on learning strategy use is performed using self-report questionnaires. As this method is accompanied by several drawbacks, we chose a qualitative, in-depth approach to inquire about students' strategies and to investigate how students successfully self-regulate their learning. In order to paint a picture of effective learning strategy use, focus groups were organized in which previously identified, effectively self-regulating students (N = 26) were asked to explain how they approach their learning. Using a constructivist grounded theory methodology, a model was constructed describing how effective strategy users manage their learning. In this model, students are driven by a personal learning goal, adopting a predominantly qualitative, or quantitative approach to learning. While learning, students are continually engaged in active processing and self-monitoring. This process is guided by a constant balancing between adhering to established study habits, while maintaining a sufficient degree of flexibility to adapt to changes in the learning environment, assessment demands, and time limitations. Indeed, students reported using several strategies, some of which are traditionally regarded as “ineffective” (highlighting, rereading etc.). However, they used them in a way that fit their learning situation. Implications are discussed for the incorporation of desirable difficulties in higher education.

Pupillary response to complex interdependent tasks: A cognitive-load theory perspective

Pupil dilation is known to indicate cognitive load. In this study, we looked at the average pupillary responses of a cohort of 29 undergraduate students during graphical problem solving. Three questions were asked, based on the same graphical input. The questions were interdependent and comprised multiple steps. We propose a novel way of analyzing pupillometry data for such tasks on the basis of eye fixations, a commonly used eyetracking parameter. We found that pupil diameter increased during the solution process. However, pupil diameter did not always reflect the expected cognitive load. This result was studied within a cognitive-load theory model. Higher-performing students showed evidence of germane load and schema creation, indicating use of the interdependent nature of the tasks to inform their problem-solving process. However, lower-performing students did not recognize the interdependent nature of the tasks and solved each problem independently, which was expressed in a markedly different pupillary response pattern. We discuss the import of our findings for instructional design.

An In Vivo Study of Self-Regulated Study Sequencing in Introductory Psychology Courses

Study sequence can have a profound influence on learning. In this study we investigated how students decide to sequence their study in a naturalistic context and whether their choices result in improved learning. In the study reported here, 2061 undergraduate students enrolled in an Introductory Psychology course completed an online homework tutorial on measures of central tendency, a topic relevant to an exam that counted towards their grades. One group of students was enabled to choose their own study sequence during the tutorial (Self-Regulated group), while the other group of students studied the same materials in sequences chosen by other students (Yoked group). Students who chose their sequence of study showed a clear tendency to block their study by concept, and this tendency was positively associated with subsequent exam performance. In the Yoked group, study sequence had no effect on exam performance. These results suggest that despite findings that blocked study is maladaptive when assigned by an experimenter, it may actually be adaptive when chosen by the learner in a naturalistic context.

Learning Versus Performance

The primary goal of instruction should be to facilitate long-term learning—that is, to create relatively permanent changes in comprehension, understanding, and skills of the types that will support long-term retention and transfer. During the instruction or training process, however, what we can observe and measure is performance, which is often an unreliable index of whether the relatively long-term changes that constitute learning have taken place. The time-honored distinction between learning and performance dates back decades, spurred by early animal and motor-skills research that revealed that learning can occur even when no discernible changes in performance are observed. More recently, the converse has also been shown—specifically, that improvements in performance can fail to yield significant learning—and, in fact, that certain manipulations can have opposite effects on learning and performance. We review the extant literature in the motor- and verbal-learning domains that necessitates the distinction between learning and performance. In addition, we examine research in metacognition that suggests that people often mistakenly interpret their performance during acquisition as a reliable guide to long-term learning. These and other considerations suggest that the learning–performance distinction is critical and has vast practical and theoretical implications.

Impact of virtual training environments on the acquisition and transfer of knowledge

Virtual training environments are appropriate to train complex tasks that require collaboration and interaction among the members of a team, especially if training in reality is not possible, too expensive or too dangerous. The field study reported in this paper compared three training conditions (virtual condition, standard condition, and control condition). The participants were police officers who were being trained in the communication between ground forces and a helicopter crew during an operation. This task (like many other tasks of the police, fire brigade and emergency services) is of high complexity and has no single "correct" solution, is based on specialization of tasks within a team, requires intensive communication among team members, and consists of situations in which human beings are in danger. Learning outcomes and knowledge transfer were measured as dependent variables. The results validate that virtual training was as efficient as standard training with regard to knowledge acquisition, and it was even more efficient with regard to knowledge transfer. With regard to the perceived value of the training, the participants judged standard training to be better than virtual training (except for training satisfaction, where no difference was found between standard and virtual training). These results indicate that virtual training is an effective tool for training in complex tasks that require collaboration and cannot fully be trained for in reality.

Improving Students’ Learning With Effective Learning Techniques

Many students are being left behind by an educational system that some people believe is in crisis. Improving educational outcomes will require efforts on many fronts, but a central premise of this monograph is that one part of a solution involves helping students to better regulate their learning through the use of effective learning techniques. Fortunately, cognitive and educational psychologists have been developing and evaluating easy-to-use learning techniques that could help students achieve their learning goals. In this monograph, we discuss 10 learning techniques in detail and offer recommendations about their relative utility. We selected techniques that were expected to be relatively easy to use and hence could be adopted by many students. Also, some techniques (e.g., highlighting and rereading) were selected because students report relying heavily on them, which makes it especially important to examine how well they work. The techniques include elaborative interrogation, self-explanation, summarization, highlighting (or underlining), the keyword mnemonic, imagery use for text learning, rereading, practice testing, distributed practice, and interleaved practice.

To offer recommendations about the relative utility of these techniques, we evaluated whether their benefits generalize across four categories of variables: learning conditions, student characteristics, materials, and criterion tasks. Learning conditions include aspects of the learning environment in which the technique is implemented, such as whether a student studies alone or with a group. Student characteristics include variables such as age, ability, and level of prior knowledge. Materials vary from simple concepts to mathematical problems to complicated science texts. Criterion tasks include different outcome measures that are relevant to student achievement, such as those tapping memory, problem solving, and comprehension.

We attempted to provide thorough reviews for each technique, so this monograph is rather lengthy. However, we also wrote the monograph in a modular fashion, so it is easy to use. In particular, each review is divided into the following sections: General description of the technique and why it should work How general are the effects of this technique?  2a. Learning conditions  2b. Student characteristics  2c. Materials  2d. Criterion tasks Effects in representative educational contexts Issues for implementation Overall assessment

The review for each technique can be read independently of the others, and particular variables of interest can be easily compared across techniques.

To foreshadow our final recommendations, the techniques vary widely with respect to their generalizability and promise for improving student learning. Practice testing and distributed practice received high utility assessments because they benefit learners of different ages and abilities and have been shown to boost students’ performance across many criterion tasks and even in educational contexts. Elaborative interrogation, self-explanation, and interleaved practice received moderate utility assessments. The benefits of these techniques do generalize across some variables, yet despite their promise, they fell short of a high utility assessment because the evidence for their efficacy is limited. For instance, elaborative interrogation and self-explanation have not been adequately evaluated in educational contexts, and the benefits of interleaving have just begun to be systematically explored, so the ultimate effectiveness of these techniques is currently unknown. Nevertheless, the techniques that received moderate-utility ratings show enough promise for us to recommend their use in appropriate situations, which we describe in detail within the review of each technique.

Five techniques received a low utility assessment: summarization, highlighting, the keyword mnemonic, imagery use for text learning, and rereading. These techniques were rated as low utility for numerous reasons. Summarization and imagery use for text learning have been shown to help some students on some criterion tasks, yet the conditions under which these techniques produce benefits are limited, and much research is still needed to fully explore their overall effectiveness. The keyword mnemonic is difficult to implement in some contexts, and it appears to benefit students for a limited number of materials and for short retention intervals. Most students report rereading and highlighting, yet these techniques do not consistently boost students’ performance, so other techniques should be used in their place (e.g., practice testing instead of rereading).

Our hope is that this monograph will foster improvements in student learning, not only by showcasing which learning techniques are likely to have the most generalizable effects but also by encouraging researchers to continue investigating the most promising techniques. Accordingly, in our closing remarks, we discuss some issues for how these techniques could be implemented by teachers and students, and we highlight directions for future research.