Title: Efficacy of Microbiology Memes in the Medical School Curriculum
Authors: Jessica Thawley, OMS3; Sydney Bishoff, OMS3
Introduction
Memes and visual methodology of learning have become a critical part of the extracurricular learning many medical students do during their 4+ years of medical school. Our query for this shift in the way medical students learn certain topics, particularly microbiology, was if this form of visual meme-based mnemonics were an effective tool in improving medical students’ short term learning and long term retention of information when compared to traditional textual based learning.
Methods
Nine original microbiology memes with associated quiz questions were created with information and facts collected from various sources including: lecture material, First Aid, PubMed, and MEDLINE. Our research participants included volunteers from the class of 2024, who were current first years at that time. The study was subject-blinded, as the participants were randomized into two groups- one who would receive the meme each week and the other who would receive a paragraph of text describing the information presented in the meme, both with the same associated quiz questions. The quiz questions included 5 new questions about the meme or paragraph sent to the students via a Moodle research tab, as well as long-term retention questions about memes or paragraphs that had previously been presented to the students. These long-term retention questions were chosen from the original 5 questions and added to the quiz questions 2 weeks after the original information was sent out, and then again 4 weeks after. The scores and data from the quizzes were collected and analyzed via an unpaired t-test to evaluate the differences in overall scores between the two groups.
Results
The t-test produced a p-value of 0.0916, which is considered not statistically significant.
Other data includes:
| Group | Group 1 | Group 2 |
| Mean | 73.0563 | 77.6556 |
| SD | 25.4880 | 19.9757 |
| SEM. | 6.3720 | 4.9939 |
| N | 16 | 16 |
Discussion
Overall, we believe that the research project was a success in answering our research question, in that there does not seem to be a significant difference in meme learning vs. traditional textual based learning for our group of students. However, the data was very close to being statistically significant, so improvements to this project including more participants, alterations to the methodology including adding a textual explanation to the memes to improve understanding, or an increased duration of the project could prove that a statistically significant relationship is present.
A question from a judge: When I listened to your presentation, I was treated to a recitation of the first slide on FOUR occasions. But my major concern is: What did the power calculation suggest was the “correct” number of subjects? Given that you had 16 subjects in each group, I worry that you were FAR too optimistic in your expectations!
Hi Dr. Elliott, thank you for your comment! Sorry about the technical difficulties with the presentation, we’re not sure what happened when they uploaded it!
We intended to have a larger sample size for our project, but unfortunately it was based on volunteers from the first year class, so we didn’t have as many participants as we hoped. The results of the power calculation suggested for an 80% power to detect a difference was a total of 958 participants. So yes, we would definitely agree that our sample size was small and that a larger research group would have yielded more accurate data. But, we would hope to continue the study throughout various first year classes or increase the length of the study in order to obtain more data points.
Hello, I am NOT a judge for your project, but I did not have the issue Dr. Elliott reported above with your presentation. I also wondered if you think surveying or interviewing students on study habits during medical school, and again at a future point (e.g., after board exam COMLEX 1 is completed) could yield additional worthwhile results on this issue. Thanks for your efforts here!
Hi Dr. Briggs Early, thank you for your comment!
We think that is an excellent idea! It would be interesting to see if there is a relationship between the different types of study habits and higher scores on board examinations etc. There could be an interesting correlation within the study if you used those results in the conclusion section to speak about patters of study habits and the possibility of moving more towards extracurricular sources or these visual mnemonics.
In addition to the power issue already noted, as a judge I wonder what the prior research in this area suggests. The presentation suggests this is becoming a more common approach to teaching and learning. Please speak to prior work in this area with similar content and populations, what did those studies (that you presumably did to guide your study) find? Similarly, what does this study add to existing literature on this topic? Thanks!
Thank you for your question! Prior work in this area has looked at the benefits of mnemonic tools specifically for medical students. The existing literature has demonstrated mnemonics can be an effective tool in medical topic comprehension. For example, Yang et. al. compared the use of mnemonics to traditional text based material for the retention of medical topics and showed that the mnemonic group preformed significantly better than the text based group (P < 0.001). We also looked at a previous PNWU research paper Thompson et. al. compared the effectiveness of mnemonic vs self study to interpret a lateral chest x ray, which demonstrated the mnemonic group also preformed significantly better (P = 0.001). Since this is a relatively new area of research, not many papers or studies exist, but our study adds to this growing body of data that can be used in the future as a model for further research or educational purposes!
Yang A, Goel H, Bryan M, Robertson R, Lim J, Islam S, Speicher MR. The Picmonic(®) Learning System: enhancing memory retention of medical sciences, using an audiovisual mnemonic Web-based learning platform. Adv Med Educ Pract. 2014 May 8;5:125-32. doi: 10.2147/AMEP.S61875. PMID: 24868180; PMCID: PMC4029202.
Thompson M, Johansen D, Stoner R, Jarstad A, Sorrells R, McCarroll ML, Justice W. Comparative effectiveness of a mnemonic-use approach vs. self-study to interpret a lateral chest X-ray. Adv Physiol Educ. 2017 Dec 1;41(4):518-521. doi: 10.1152/advan.00034.2017. PMID: 28978520.
Thank you for your presentation. As a judge, I am wondering if you looked at long-term retention of the material. Your design included test questions from previously covered material but I do not see where that data is examined.
Thank you for your question! We did assess long term retention of the material as well as short term retention through our quizzes. There were more questions based on short term retention up front, but 2 checks (of one question each) of long term retention after the original meme was presented. These scores were included in the overall averages of the quizzes, so we did not do an individual data assessment of the long term retention questions. This is another aspect we want to improve on for future projects!