Article Review: Literature review of computer animations for medical education

"Animation is a series of images designed so that each image appears an alteration of the previous one, and in which the sequence of images is determined by either the designer or the user."

I came across this article evaluating the effectiveness of computer animation in learning, after having build an EM radiology animation module in a previous blog post. While I think it's cool, it would be nice to know if this approach to learning is better than showing just static images. From an instructor's standpoint, still images would be much easier to create.

There were many fascinating concepts in this article. For me, there were 4 key take-home points from:

1. There are very few (and often conflicting) studies evaluating the effectiveness of animation vs static images in medical education.
2. Allowing learner control of the animation pace improves the effectiveness of the animation.
3. Building shorter (more digestible) animation pieces improves the effectiveness of the animation.
4. There is a "cognitive load theory" which attempts to explain how people learn. The authors describe how animation fits into this framework.

Cognitive Load Theory Humans have a "working memory" center, which processes new information. Some of this information is stored in "long-term memory". There are 2 major types of information, or "cognitive loads".

• Germane load: Information that contributes to learning.
• Extraneous cognitive load: Information that takes up cognitive "space" in your working memory but does NOT add to effective learning.

Extraneous cognitive load (a.k.a white noise) wouldn't be a problem for learning except that our working memory has only a limited capacity for information. This contrasts long-term memory, which has no limits. So the goal behind teaching should be to maximize germane and minimize extraneous cognitive loads.

Cognitive Theory on Multimedia Learning
This theory builds on the "cognitive load theory" concept. It is known that people process information using visual and auditory pathways. Learning is improved if both pathways are engaged. That means both images and spoken words should be used (keeping in mind to minimize the extraneous cognitive load) to optimize teaching and learning.


So bringing this back to animation, what should we keep in mind if building animations for education?
Animations are not always superior to still images. Ask yourself, will the animation be more distracting than useful? Will this be considered a germane of extraneous cognitive load? Preliminary studies showed that building user-triggered controls, where the learner can control the animation pace or flow, improves learning comprehension.

Table 2 poses some interesting research questions, if you are interested in pursuing research in this area.

Click to enlarge table.

Reference:
Ruiz JG, Cook DA, Levinson AJ. Computer animations in medical education: a critical literature review. Med Educ 2009;43:838-46.