Distributing learning over time: the spacing effect in children's acquisition and generalization of science concepts

Feature variability determines specificity and transfer in multiorientation feature detection learning

Historically, in many perceptual learning experiments, only a single stimulus is practiced, and learning is often specific to the trained feature. Our prior work has demonstrated that multi-stimulus learning (e.g., training-plus-exposure procedure) has the potential to achieve generalization. Here, we investigated two important characteristics of multi-stimulus learning, namely, roving and feature variability, and their impacts on multi-stimulus learning and generalization. We adopted a feature detection task in which an oddly oriented target bar differed by 16° from the background bars. The stimulus onset asynchrony threshold between the target and the mask was measured with a staircase procedure. Observers were trained with four target orientation search stimuli, either with a 5° deviation (30°-35°-40°-45°) or with a 45° deviation (30°-75°-120°-165°), and the four reference stimuli were presented in a roving manner. The transfer of learning to the swapped target-background orientations was evaluated after training. We found that multi-stimulus training with a 5° deviation resulted in significant learning improvement, but learning failed to transfer to the swapped target-background orientations. In contrast, training with a 45° deviation slowed learning but produced a significant generalization to swapped orientations. Furthermore, a modified training-plus-exposure procedure, in which observers were trained with four orientation search stimuli with a 5° deviation and simultaneously passively exposed to orientations with high feature variability (45° deviation), led to significant orientation learning generalization. Learning transfer also occurred when the four orientation search stimuli with a 5° deviation were presented in separate blocks. These results help us to specify the condition under which multistimuli learning produces generalization, which holds potential for real-world applications of perceptual learning, such as vision rehabilitation and expert training.

Does the public know what researchers know? Perceived task difficulty impacts adults' intuitions about children's early word learning

The present study examined adults' understanding of children's early word learning. Undergraduates, non-parents, parents, and Speech-Language Pathologists (N = 535, 74% female, 56% White) completed a survey with 11 word learning principles from the perspective of a preschooler. Questions tested key principles from early word learning research. For each question, participants were prompted to select an answer based on the perspective of a preschooler. Adults demonstrated aligned intuitions for all principles except those derived from domain-general theories, regardless of experience with language development (Experiment 1). Experiment 2 revealed that perceived difficulty of a task for a preschooler impacted adults' reasoning about word learning processes. Experiment 3 ruled out level of confidence and interest as mechanisms to explain the results. These results highlight disconnects in knowledge between the cognitive development research community and the general public. Therefore, efforts must be made to communicate scientific findings to the broader non-academic community, emphasizing children's ability to excel at word learning in the face of task difficulty.

How to Continue? New Approaches to Investigating the Effects of Adaptive Math Learning Programs on Students' Performance, Self-Concept, and Anxiety

Math learning programs were expected to revolutionize students' learning, but their effects so far have mostly been disappointing. Following the debate about why to continue research on math learning programs, we aimed to reformulate this question into how to continue this research. Investigations to date have neither considered a sufficiently wide set of outcome variables nor differentiated between performance measures (e.g., measuring addition and subtraction performance separately) and affective-motivational variables. Moreover, as students can only benefit from a program if they use it, researchers need to take practice behavior into account. Thus, we investigated whether the adaptive arithmetic learning program Math Garden fostered students' addition and subtraction performance, their math self-concept, and a reduction of their math anxiety. We also investigated how practice behavior (practiced tasks/weeks) affected these outcomes. We used a randomized pretest-posttest control group design with 376 fifth-grade students in Germany. Students in the experimental condition practiced with Math Garden for 20.7 weeks and had an increase in math self-concept. The more subtraction tasks the students practiced, the more they improved their subtraction performance. We found no effects on math anxiety. The results are discussed in terms of providing a starting point for new directions in future research.

Using Spacing to Promote Lasting Learning in Educational Contexts

Abstract. Spacing repeated study phases across multiple sessions instead of studying and restudying the learning material in one session only is an effective strategy to promote lasting learning. However, most studies demonstrating the spacing effect were conducted in the laboratory, using simple verbal material. Learning in educational contexts differs regarding the complexity and coherence of the learning material and concerning the role of motivational and affective learner characteristics. Studies conducted in educational contexts suggest that the spacing effect is not as robust here. For example, acquiring mathematical skills or nonrepeated, consecutive information does not reliably benefit from spacing. After an overview of studies addressing the spacing effect in the laboratory and in educational contexts, we discuss various open questions that need to be addressed by future research before recommending spacing as a learning strategy to promote meaningful and lasting learning at schools and universities.

Judging the credibility of websites: an effectiveness trial of the spacing effect in the elementary classroom

Spaced learning—the spacing effect—is a cognitive phenomenon whereby memory for to-be-learned material is better when a fixed amount of study time is spread across multiple learning sessions instead of crammed into a more condensed time period. The spacing effect has been shown to be effective across a wide range of ages and learning materials, but few studies have been conducted that look at whether spacing can be effective in real-world classrooms, using real curriculum content, with real teachers leading the intervention. In the current study, lesson plans for teaching website credibility were distributed to homeroom elementary teachers with specific instructions on how to manipulate the timing of the lessons for either a one-per-day or one-per-week delivery. One month after the final lesson, students were asked to apply their knowledge on a final test, where they evaluated two new websites. Results were mixed, suggesting that classroom noise might lessen or impede researchers’ ability to find spacing effects in naturalistic settings.

Practice schedule and testing per se affect children's transfer abilities in a grapho-motor task

Children's ability to transfer the gains of a motor experience, such as learning to write a letter, to novel conditions, such as cursive writing of the same letter, are affected by the way in which the learning experience is parsed. Parsing may have limitations because a short session may hamper the engagement of procedural memory consolidation processes. Here, we compared the effects of two practice schedules with the total amount of practice identical training provided in a single-session practice versus multi-session practice, wherein each session on its own was insufficient for generating long-term gains. A total of 40 7- and 8-year-old children practiced the production of a novel letter form by connecting dots, namely, the Invented Letter Task (ILT). Multiple ILT-related transfer tasks were assessed at 24 h post-training and again at 4-5 weeks post-training. Although by the end of training the single-session practice group outperformed the multi-session practice group in speed and accuracy, at 24 h post-training both groups showed comparable gains. However, after multi-session practice, children were as fast or faster and more accurate in the transfer tasks. By 4-5 weeks post-training, the multi-session practice group showed larger gains in the trained condition, a speed advantage in the transfer tasks, and a significant improvement on the transfer tasks. The results suggest that parsing training over several brief sessions may lead to long-term gains in children's grapho-motor skills. Moreover, multi-session practice protocols may contribute to the potential for transfer and to more effective learning from experiences such as transfer tasks.

The effects of spacing and massing on children's orthographic learning

Despite substantial evidence that spacing study opportunities over time improves the retention of learned verbal material compared with study trials that occur consecutively, the influence of temporal spacing on children's learning of written words has not been investigated. This experiment examined whether temporal spacing influenced Grade 3 and 4 children's (N = 37; mean age = 8 years 7 months) learning of novel written words during independent reading compared with massing. Children read 16 sentences containing a novel word under either a spaced (sentences appeared once in each of four blocks) or massed conditions (four consecutive trials). After a delay, orthographic learning was assessed using recognition (orthographic choice) and recall (spelling to dictation) measures. Words experienced in the spaced condition were better recognized than those in the massed condition, but there was no effect on recall. These findings suggest that temporal spacing influences the acquisition of new written word forms, extending the potential utility of the spacing principle to reading acquisition.

Beyond the Distributed Practice Effect: Is Distributed Learning Also Effective for Learning With Non-repeated Text Materials?

Distributed learning is often recommended as a general learning strategy, but previous research has established its benefits mainly for learning with repeated materials. In two experiments, we investigated distributed learning with complementary text materials. 77 (Experiment 1) and 130 (Experiment 2) seventh graders read two texts, massed vs. distributed, by 1 week (Experiment 1) or 15 min (Experiment 2). Learning outcomes were measured immediately and 1 week later and metacognitive judgments of learning were assessed. In Experiment 1, distributed learning was perceived as more difficult than massed learning. In both experiments, massed learning led to better outcomes immediately after learning but learning outcomes were lower after 1 week. No such decrease occurred for distributed learning, yielding similar outcomes for massed and distributed learning after 1 week. In sum, no benefits of distributed learning vs. massed learning were found, but distributed learning might lower the decrease in learning outcomes over time.

Artificial grammar learning is facilitated by distributed practice: Evidence from a letter reordering task

Previous studies have shown that distributed practice-a training strategy that is known to facilitate memory-is likely to result in greater learning than massed practice. This effect has been demonstrated largely in explicit tasks. The purpose of this study was to test whether statistical learning of artificial grammar is affected by the lag between learning sessions overall, and by high and low complexity stimuli (as measure by chunk strength). Two groups (spaced-short and spaced-long) learned strings of letters created according to a set of rules and were required to produce new strings using given letter sets. For the spaced-short group, the two learning sessions, each including training and a test phase, took place sequentially with a 10-min break, whereas for the spaced-long group, learning sessions were distributed across two days (1-day lag). Overall results showed improved performance following spaced-long practice compared to spaced-short practice. The results also indicated that in the low chunk strength strings (indicating high complexity), both groups demonstrated similar improvement from first to second testing, while in the high chunk strength strings (indicating low complexity), improvement in letter reordering performance was significantly higher when the learning sessions were distributed across two days. This pattern of findings suggests that stimuli complexity affects the extent to which distributed practice enhance artificial grammar learning.

Understanding relational binding in early childhood: Interacting effects of overlap and delay

Episodic memories typically share overlapping elements in distinctive combinations, and to be valuable for future behavior they need to withstand delays. There is relatively little work on whether children have special difficulty with overlap or withstanding delay. However, Yim, Dennis, and Sloutsky (Psychological Science, 2013, Vol. 24, pp. 2163-2172) suggested that extensive overlap is more problematic for younger children, and Darby and Sloutsky (Psychological Science, 2015, Vol. 26, pp. 1937-1946) reported that a 48-h delay period actually improves children's memory for overlapping pairs of items. In the current study, we asked how children's episodic memory is affected by stimulus overlap, delay, and age using visual stimuli containing either overlapping or unique item pairs. Children aged 4 and 6 years were tested both immediately and after a 24-h delay. As expected, older children performed better than younger children, and both age groups performed worse on overlapping pairs. Surprisingly, the 24-h delay had only a marginal effect on overall accuracy. Although there were no interactions, when errors were examined, there was evidence that delay buffered memory for overlapping pairs against cross-contextual confusion for younger children.

Spacing and Interleaving Effects Require Distinct Theoretical Bases: a Systematic Review Testing the Cognitive Load and Discriminative-Contrast Hypotheses

Spaced and interleaved practices have been identified as effective learning strategies which sometimes are conflated as a single strategy and at other times treated as distinct. Learning sessions in which studying information or practicing problems are spaced in time with rest-from-deliberate-learning periods between sessions generally result in better learning outcomes than massed practice without rest-from-deliberate-learning periods. Interleaved practice also consists of spaced sessions, but by interleaving topics rather than having rest-from-deliberate-learning periods. Interleaving is usually contrasted with blocking in which each learning topic is taught in a single block that provides an example of massed practice. The general finding that interleaved practice is more effective for learning than blocked practice is sometimes attributed to spacing. In the current paper, the presence of rest-from-deliberate-learning periods is used to distinguish between spaced and interleaved practice. We suggest that spaced practice is a cognitive load effect that can be explained by working memory resource depletion during cognitive effort with recovery during rest-from-deliberate-learning, while interleaved practice can be explained by the discriminative-contrast hypothesis positing that interleaving assists learners to discriminate between topic areas. A systematic review of the literature provides evidence for this suggestion.

The moral, or the story? Changing children's distributive justice preferences through social communication

Can social communication alter children's preexisting inclinations toward equality-based or merit-based forms of resource distribution? Six- to eight-year-old children's (N = 248) fairness preferences were evaluated with third-party distribution tasks before and after an intervention. Study 1 indicated that stories about beavers dividing wood had no impact on children's fairness preferences, while Study 2 indicated that brief, direct testimony was highly influential. Study 3 matched storybooks and testimony in content, with each discussing a situation resembling the distribution task, and both formats exerted a significant impact on children's fairness preferences that persisted across several weeks. There were some indications that interventions preaching the superiority of equality-based fairness were particularly effective, but there were no differences between reason-based and emotion-based interventions. Overall, storybooks and testimony can powerfully and enduringly change children's existing distributive justice preferences, as long as the moral lessons that are conveyed are easily transferable to children's real-world contexts.

Forgetting and symbolic insight: Delay improves children's use of a novel symbol

To use a symbol, children must understand that the symbol stands for something in the world. This development has often been investigated in the model-room task in which children use a scale model to try to find a toy that is hidden in the room that the model represents. To succeed, children must acquire dual representation; they must put aside their understanding of the model as an object and focus more on what the model represents. Here we suggested that forgetting irrelevant details or misleading information may be an important part of acquiring and maintaining dual representation. Based on prior research showing that forgetting can promote insight in children and adults and that a small sample of 3-year-olds could improve on the model-room task with a delay, we hypothesized that taking a break during the model-room task would facilitate forgetting and hence symbolic insight. A total of 88 3-year-olds performed 8 trials of the model-room task. Half of the children received a 24-h delay after Trial 4, and half performed the 8 trials consecutively. Children who received a 24-h delay had better symbolic performance on the last 4 trials compared with children whose testing sessions occurred consecutively on 1 day, even when statistically controlling for the effects of learning over trials and memory on children's performance. This study provides strong initial evidence that a delay can promote symbolic insight in 3-year-old children.

Promoting Low-Income Preschoolers' Vocabulary Learning From Educational Media: Does Repetition Support Memory for Learned Word Knowledge?

Children from diverse backgrounds are able to learn new words from educational media. However, learning is often partial and fragile, leaving much room for uncovering strategies that can increase the efficacy of educational media in supporting children's vocabulary knowledge. The present study investigated one such strategy—repeated viewing of educational media—in a sample of low-income preschoolers. One hundred thirty one preschoolers were randomly assigned to view an educational media clip teaching three vocabulary words in one of three conditions: (a) once, (b) three times in immediate succession (massed repetition), or (c) three times with views spaced 1 hour apart (spaced repetition). Children completed a target vocabulary assessment both immediately after the final view and 1 week later. Results indicate that certain types of word knowledge were supported by repetition, particularly spaced repetition. Children also effectively retained the vocabulary knowledge they acquired from educational media over a 1-week period in all conditions. This suggests that educational media is a strong platform for teaching low-income preschoolers new words, and that spaced repetition might further support low-income preschoolers' vocabulary learning.

Maximizing Treatment Efficiency in Developmental Language Disorder: Positive Effects in Half the Time

Purpose When a behavioral treatment is generally efficacious, the central research questions shift to optimized dose delivery. In this study, we determine whether a validated treatment method can be made more effective or efficient by increasing the dose density employed. Method Twenty children were treated with Enhanced Conversational Recast methods to treat morphological errors. Half received 24 doses per session within a half hour (approximately 1 dose/1.25 min), and the other received the same number of doses within 15 min (approximately 1 dose/38 s). Generalization of morpheme use was probed throughout treatment and at a 6-week follow-up. Spontaneous use of treated morphemes was also tracked. Results Although the treatment was effective overall, there were no significant differences between treatment conditions on any of the outcome measures. Follow-up performance correlated significantly with performance at the end of the treatment period. Conclusion Minimal between-groups differences suggest that performance does not suffer when dose rates are compressed into half the time during treatment, making the high-density dose delivery method a more efficient delivery method. This could make time available within a treatment session to address other goals or allow for more classroom instructional time for the child. Supplemental Material https://doi.org/10.23641/asha.8968559.

Spaced training improves learning in Ts65Dn and Ube3a mouse models of intellectual disabilities

Benefits of distributed learning strategies have been extensively described in the human literature, but minimally investigated in intellectual disability syndromes. We tested the hypothesis that training trials spaced apart in time could improve learning in two distinct genetic mouse models of neurodevelopmental disorders characterized by intellectual impairments. As compared to training with massed trials, spaced training significantly improved learning in both the Ts65Dn trisomy mouse model of Down syndrome and the maternally inherited Ube3a mutant mouse model of Angelman syndrome. Spacing the training trials at 1 h intervals accelerated acquisition of three cognitive tasks by Ts65Dn mice: (1) object location memory, (2) novel object recognition, (3) water maze spatial learning. Further, (4) spaced training improved water maze spatial learning by Ube3a mice. In contrast, (5) cerebellar-mediated rotarod motor learning was not improved by spaced training. Corroborations in three assays, conducted in two model systems, replicated within and across two laboratories, confirm the strength of the findings. Our results indicate strong translational relevance of a behavioral intervention strategy for improving the standard of care in treating the learning difficulties that are characteristic and clinically intractable features of many neurodevelopmental disorders.

Distributed Learning in the Classroom: Effects of Rereading Schedules Depend on Time of Test

Research with adults in laboratory settings has shown that distributed rereading is a beneficial learning strategy but its effects depend on time of test. When learning outcomes are measured immediately after rereading, distributed rereading yields no benefits or even detrimental effects on learning, but the beneficial effects emerge two days later. In a preregistered experiment, the effects of distributed rereading were investigated in a classroom setting with school students. Seventh-graders (N = 191) reread a text either immediately or after 1 week. Learning outcomes were measured after 4 min or 1 week. Participants in the distributed rereading condition reread the text more slowly, predicted their learning success to be lower, and reported a lower on-task focus. At the shorter retention interval, massed rereading outperformed distributed rereading in terms of learning outcomes. Contrary to students in the massed condition, students in the distributed condition showed no forgetting from the short to the long retention interval. As a result, they performed equally well as the students in the massed condition at the longer retention interval. Our results indicate that distributed rereading makes learning more demanding and difficult and leads to higher effort during rereading. Its effects on learning depend on time of test, but no beneficial effects were found, not even at the delayed test.

Quantity and Diversity: Simulating Early Word Learning Environments

The words in children's language learning environments are strongly predictive of cognitive development and school achievement. But how do we measure language environments and do so at the scale of the many words that children hear day in, day out? The quantity and quality of words in a child's input are typically measured in terms of total amount of talk and the lexical diversity in that talk. There are disagreements in the literature whether amount or diversity is the more critical measure of the input. Here we analyze the properties of a large corpus (6.5 million words) of speech to children and simulate learning environments that differ in amount of talk per unit time, lexical diversity, and the contexts of talk. The central conclusion is that what researchers need to theoretically understand, measure, and change is not the total amount of words, or the diversity of words, but the function that relates total words to the diversity of words, and how that function changes across different contexts of talk.

Distributed retrieval practice promotes superior recall of anatomy information

Effortful retrieval produces greater long-term recall of information when compared to studying (i.e., reading), as do learning sessions that are distributed (i.e., spaced apart) when compared to those that are massed together. Although the retrieval and distributed practice effects are well-established in the cognitive science literature, no studies have examined their additive effect with regard to learning anatomy information. The aim of this study was to determine how the benefits of retrieval practice vary with massed versus distributed learning. Participants used the following strategies to learn sets of skeletal muscle anatomy: (1) studying on three different days over a seven day period (SSSS_7,2,0 ), (2) studying and retrieving on three different days over a seven day period (SRSR_7,2,0 ), (3) studying on two different days over a two day period (SSSSSS_2,0 ), (4) studying and retrieving on two separate days over a two day period (SRSRSR_2,0 ), and (5) studying and retrieving on one day (SRx6₀ ). All strategies consisted of 12 learning phases and lasted exactly 24 minutes. Muscle information retention was assessed via free recall and using repeated measures ANOVAs. A week after learning, the recall scores were 24.72 ± 3.12, 33.88 ± 3.48, 15.51 ± 2.48, 20.72 ± 2.94, and 12.86 ± 2.05 for the SSSS_7,2,0 , SRSR_7,2,0 , SSSSSS_2,0 , STSTST_2,0 , and SRx6₀ strategies, respectively. In conclusion, the distributed strategies produced significantly better recall than the massed strategies, the retrieval-based strategies produced significantly better recall than the studying strategies, and the combination of distributed and retrieval practice generated the greatest recall of anatomy information. Anat Sci Educ 10: 339-347. © 2016 American Association of Anatomists.

Spacing Repetitions Over Long Timescales: A Review and a Reconsolidation Explanation

Recent accounts of the spacing effect have proposed molecular explanations that explain spacing over short, but not long timescales. In the first half of this paper, we review research on the spacing effect that has employed spaces of 24 h or more across skill-related tasks, language-related tasks and generalization for adults and children. Throughout this review, we distinguish between learning and retention by defining learning (or acquisition) as performance at the end of training and retention as performance after a delay period. Using this distinction, we find age- and task-related differences in the manifestation of the spacing effect over long timescales. In the second half of this paper, we discuss a reconsolidation account of the spacing effect. In particular, we review the evidence that suggests the spacing of repetitions influences the subsequent consolidation and reconsolidation processes; we explain how a reconsolidation account may explain the findings for learning; the inverted-U curve for retention; and compare the reconsolidation account with previous consolidation accounts of the spacing effect.

The Spacing Effect for Structural Synaptic Plasticity Provides Specificity and Precision in Plastic Changes

In contrast to trials of training without intervals (massed training), training trials spaced over time (spaced training) induce a more persistent memory identified as long-term memory (LTM). This phenomenon, known as the spacing effect for memory, is poorly understood. LTM is supported by structural synaptic plasticity; however, how synapses integrate spaced stimuli remains elusive. Here, we analyzed events of structural synaptic plasticity at the single-synapse level after distinct patterns of stimulation in motoneurons of Drosophila We found that the spacing effect is a phenomenon detected at synaptic level, which determines the specificity and the precision in structural synaptic plasticity. Whereas a single pulse of stimulation (massed) induced structural synaptic plasticity, the same amount of stimulation divided in three spaced stimuli completely prevented it. This inhibitory effect was determined by the length of the interstimulus intervals. The inhibitory effect of the spacing was lost by suppressing the activity of Ras or mitogen-activated protein kinase, whereas the overexpression of Ras-WT enhanced it. Moreover, dividing the same total time of stimulation into five or more stimuli produced a higher precision in the number of events of plasticity. Ras mutations associated with intellectual disability abolished the spacing effect and led neurons to decode distinct stimulation patterns as massed stimulation. This evidence suggests that the spacing effect for memory may result from the effect of the spacing in synaptic plasticity, which appears to be a property not limited to neurons involved in learning and memory. We propose a model of spacing-dependent structural synaptic plasticity.SIGNIFICANCE STATEMENT Long-term memory (LTM) induced by repeated trials spaced over time is known as the spacing effect, a common property in the animal kingdom. Altered mechanisms in the spacing effect have been found in animal models of disorders with intellectual disability, such as Noonan syndrome. Although LTM is sustained by structural synaptic plasticity, how synapses integrate spaced stimuli and decode them into specific plastic changes remains elusive. Here, we show that the spacing effect is a phenomenon detected at the synaptic level, which determines the properties of the response in structural plasticity, including precision of such response. Whereas suppressing or enhancing Ras/mitogen-activated protein kinase signaling changed how synapses decode a pattern of stimuli, a disease-related Ras allele abolished the spacing effect for plastic changes.

2.5-year-olds' retention and generalization of novel words across short and long delays

Two experiments investigated two-year-olds' retention and generalization of novel words across short and long time delays. Specifically, retention of newly learned words and generalization to novel exemplars or novel contexts were tested one minute or one week after learning. Experiment 1 revealed successful retention as well as successful generalization to both new exemplars and new contexts after a one-minute delay, with no statistical differences between retention and generalization performance for either generalization type. Toddlers tested after a week delay (Experiment 2) showed successful retention and generalization as well, but while context generalization was statistically equivalent to retention accuracy, exemplar generalization was significantly lower than retention accuracy. The overall success in both retention and generalization suggests that toddlers' newly learned words are robust and flexible. However, the lower exemplar generalization performance compared to retention after a weeklong delay suggests that novel words may become less flexible across exemplar characteristics over time.

Algorithm-Driven Dosage Decisions (AD3): Optimizing Treatment for Children With Language Impairment

BACKGROUND

This study was designed to provide recommended amounts of treatment to achieve the optimal amount of language gain for children with language impairment.

METHOD

The authors retrospectively analyzed treatment outcomes for 233 children for delivered dose, intensity, and cumulative intensity of therapy. The steps of the analytical process they applied to arrive at algorithms for recommended amounts of treatment were (1) multilevel modeling to predict children's language gains from the 3 intensity parameters and (2) extraction of regression weights to create a recommended amount of treatment.

RESULTS

Optimal outcomes can be identified using an equation specifying Ŷ = desired points of change (e.g., 0.6 SD units), V = child's baseline language skills, D = average number of minutes spent targeting language in a session, F = total number of sessions conducted across the year, and D × F = product of planned dose and frequency (cumulative intensity). Input of the values for Ŷ and V provides recommended amount of treatment.

CONCLUSIONS

This study constitutes the first effort to provide empirical guidance on intensity of treatment for children with language impairment. The use of algorithm-driven dosage recommendations may be more effective than clinician judgment and trial and error, although these correlational results must be confirmed with experimental methods.

An Online Learning Module to Increase Self-Efficacy and Involvement in Care for Patients With Advanced Lung Cancer: Research Protocol

Background

Improving patient care for individuals with lung cancer is a priority due to the increasing burden of the disease globally. One way this can be done is by improving patient self-management capabilities through increasing their self-efficacy. This can improve positive outcomes for patients with chronic conditions and increase their ability to manage the challenges of such illnesses. Unfortunately, patients with chronic conditions often struggle to travel far from home to engage with patient education events, a common means of improving self-efficacy. The development of more accessible tools for improving patient self-efficacy is required to increase quality of life for patients with chronic conditions.

Objective

To evaluate the feasibility of delivering symptom identification and management information to patients with advanced lung cancer using an online program.

Methods

This article describes a pre-post test study to evaluate a Qstream online learning platform to improve patient self-efficacy for managing advanced lung cancer symptoms. Undertaking this program should increase participant knowledge about the side-effects they may experience as a result of their treatment and in turn increase help-seeking behavior and self-efficacy for the participant cohort. Quantitative data collected by the Qstream platform on the completion rates of participants will be used as a tool to evaluate the intervention. Additionally, validated scales will be used to collect data on patient self-efficacy. Qualitative data will also be collected via an exit survey and thematic content analysis of semi-structured interviews.

Results

The research is in the preliminary stages but thus far a protocol has been approved in support of the project. Additionally, advisory committee members have been identified and initial meetings have been undertaken.

Conclusions

Development of new approaches for increasing patient understanding of their care is important to ensure high quality care continues to be delivered in the clinical setting.

A mixed methods approach to developing and evaluating oncology trainee education around minimization of adverse events and improved patient quality and safety

BACKGROUND

Adverse events are a significant quality and safety issue in the hospital setting due to their direct impact on patients. Additionally, such events are often handled by junior doctors due to their direct involvement with patients. As such, it is important for health care organizations to prioritize education and training for junior doctors on identifying adverse events and handling them when they occur. The Cancer Cup Challenge is an educational program focuses on quality improvement and adverse event awareness targeting for junior oncology doctors across three international sites.

METHODS

A mixed methodology was used to develop and evaluate the program. The Qstream spaced learning platform was used to disseminate information to participants, as it has been demonstrated to impact on both knowledge and behavior. Eight short case based scenarios with expert feedback were developed by a multidisciplinary advisory committee containing representatives from the international sites. At the conclusion of the course impact on participant knowledge was evaluated using analysis of the metrics collected by the Qstream platform. Additionally, an online survey and semi-structured interviews were used to evaluate engagement and perceived value by participants.

RESULTS

A total of 35 junior doctors registered to undertake the Qstream program, with 31 (88.57 %) successfully completing it. Analysis of the Qstream metrics revealed 76.57 % of cases were answered correctly on first attempt. The post-program survey received 17 responses, with 76.47 % indicating cases for the course were interesting and 82.35 % feeling cases were relevant. Finally, 14 participants consented to participate in semi-structured interviews about the program, with feedback towards the course being generally very positive.

CONCLUSIONS

Our study demonstrates that an online game is well accepted by junior doctors as a method to increase their quality improvement awareness. Developing effective and sustainable training for doctors is important to ensure positive patient outcomes are maintained in the hospital setting. This is particularly important for junior doctors as they are working closely with patients and learning skills and behaviors, which will influence their practice throughout their careers.

Spaced Repetition Promotes Efficient and Effective Learning

Concern that students in the United States are less proficient in mathematics, science, and reading than their peers in other countries has led some to question whether American students spend enough time in school. Instead of debating the amount of time that should be spent in school (and on schoolwork), this article addresses how the available instructional time might be optimally utilized via the scheduling of review or practice. Hundreds of studies in cognitive and educational psychology have demonstrated that spacing out repeated encounters with the material over time produces superior long-term learning, compared with repetitions that are massed together. Also, incorporating tests into spaced practice amplifies the benefits. Spaced review or practice enhances diverse forms of learning, including memory, problem solving, and generalization to new situations. Spaced practice is a feasible and cost-effective way to improve the effectiveness and efficiency of learning, and has tremendous potential to improve educational outcomes. The article also discusses barriers to adopting spaced practice, recent developments, and their possible implications.

Designing Effective Speech-Language Interventions for Children in the Public Schools

In the U.S. public school system, more than 6 million children receive special education services, including many children with speech and language impairments. Speech-language pathologists (SLPs) design and implement effective interventions—including how much intervention children receive—to circumvent the negative effects of speech-language impairments on educational outcomes. Existing policy and position statements suggest that increasing the number of sessions (frequency) and amount of intervention (dose) would improve children’s outcomes, assuming that greater treatment intensity is associated with better treatment outcomes. However, current empirical evidence, coupled with cognitive theory, suggests that more treatment may not relate to improved outcomes. The present article draws on current empirical studies and established cognitive theories of spacing effects (learning distributed over time) to propose a systematic way for SLPs to plan and implement an effective intensity of intervention for children with speech and language impairments.

A comparative analysis of massed vs. distributed practice on basic math fact fluency growth rates

To best remediate academic deficiencies, educators need to not only identify empirically validated interventions but also be able to apply instructional modifications that result in more efficient student learning. The current study compared the effect of massed and distributed practice with an explicit timing intervention to evaluate the extent to which these modifications lead to increased math fact fluency on basic addition problems. Forty-eight third-grade students were placed into one of three groups with each of the groups completing four 1-min math explicit timing procedures each day across 19 days. Group one completed all four 1-min timings consecutively; group two completed two back-to-back 1-min timings in the morning and two back-to-back 1-min timings in the afternoon, and group three completed one, 1-min independent timing four times distributed across the day. Growth curve modeling was used to examine the progress throughout the course of the study. Results suggested that students in the distributed practice conditions, both four times per day and two times per day, showed significantly higher fluency growth rates than those practicing only once per day in a massed format. These results indicate that combining distributed practice with explicit timing procedures is a useful modification that enhances student learning without the addition of extra instructional time when targeting math fact fluency.

Developmental changes and the effect of self-generated feedback in metacognitive controlled spacing strategies in 7-year-olds, 10-year-olds, and adults

The current study investigated the development of metacognitive monitoring-based control of spacing choices in children and adults. Moreover, we assessed whether metacognitive learning decisions are influenced by the effects of previous metacognitive decisions. We tested groups of 7-year-olds, 10-year-olds, and adults in a task with two learning blocks in which they needed to monitor their learning through judgments of learning (JoL) and in which they then needed to decide whether to space their study, mass it, or terminate it. Extending previous findings, our study provides the first evidence that already by 7 years of age children can make metacognitive controlled scheduling decisions. The results also revealed that adults had more clearly differentiated strategies related to their JoL. Furthermore, our study provides evidence that participants of all age groups improved their relative monitoring accuracy in the second learning block and adjusted their JoL. However, only adults changed their strategy choices.

The unrealized promise of infant statistical word-referent learning

Recent theory and experiments offer a new solution regarding how infant learners may break into word learning by using cross-situational statistics to find the underlying word-referent mappings. Computational models demonstrate the in-principle plausibility of this statistical learning solution and experimental evidence shows that infants can aggregate and make statistically appropriate decisions from word-referent co-occurrence data. We review these contributions and then identify the gaps in current knowledge that prevent a confident conclusion about whether cross-situational learning is the mechanism through which infants break into word learning. We propose an agenda to address that gap that focuses on detailing the statistics in the learning environment and the cognitive processes that make use of those statistics.

Understanding the Distributed Practice Effect

The distributed practice effect is one of the most researched memory effects in cognitive psychology. Beneficial distributed practice effects for long-term retention have been demonstrated in different domains and they are remarkably large in size, too. However, despite strong effects, this research field still lacks a unified theory offering explanations for a wide range of findings. This article reviews empirical studies on the distributed practice effect that have immediate relevance for educational settings. Against the backdrop of this review, the article discusses theory candidates and ways of specifying them for empirical tests using nonstandard statistical methods. I conclude that future studies will have to fine-tune theories to strengthen the significance of empirical results and to allow for better recommendations to educators. This promises to increase the enthusiasm to systematically implement distributed practice in instruction routines and bridge psychological research and educational practice.