If you’re looking to help students improve performance beyond the end of the class, then spaced learning may be right for you. An evidence-based education technique, spaced learning is very different from massed learning, the “sit and learn, then go and do” style of education with which we are all familiar.
Spaced vs. Massed Learning
Massed learning (also called massed training) is the technique we use when we attempt to teach students everything we want them to know about a particular topic in a single class. Students come in for the session, absorb as much as possible in one go, practice what they can, and (hopefully) demonstrate competency at the end of the program. This is the type of education often used when students are introduced to a completely new topic, where significant foundational knowledge needs to be laid down.
When done properly this style allows some learning to occur and allows us to record that students have met required course objectives at the time of testing. But what about retention? When they move on to the next topic or problem, how much of what was taught remains? How effectively will the student perform in three weeks, three months, or three years?
While convenient to set up and schedule, massed learning-style programs may not improve students’ ability to do much more than pass an exam at the end of the course. The American Heart Association recommends shorter, more frequent learning sessions to improve long-term retention and performance as part of the complete breakfast of evidence-based education techniques outlined in its 2018 scientific statement on resuscitation education.
Sitting through an intensive massed-learning program, say 1–2 days or more, can be thought of as binge/purge education. Students wolf down as much information as possible, then regurgitate it back for an examination, often without keeping much of it for themselves. An alternative technique, spaced learning or spaced repetition, has been proven to help people learn faster over a variety of domains.
The Learning and Forgetting Curves
The learning curve is the amount of time it will take for a student from the introduction of a particular topic to when they achieve the desired performance. To help EMS providers improve long-term performance, educators must also take into account the “forgetting” curve. Most educators don’t talk about these curves together, even though they were both first described by the same person.
In the late 1800s German psychologist Hermann Ebbinghaus was studying memory, specifically how students’ ability to learn and perform declined through the school day. Through his research he developed now well-proven theories on how to improve encoding and recall of information. Rather than just focus on pushing information to students until they reached the desired peak of the learning curve and then saying “job done” when they passed the test, Ebbinghaus found performance was much improved if students were only introduced to one or two key concepts at a time, then later asked to review, recall, or apply the concepts at regular intervals. This not only helps students better absorb the information, it also helps improve their ability to retrieve and apply it when needed.
In other words, students would learn well enough to pass the test, but then their knowledge and ability to perform would naturally decay. Ebbinghaus found interrupting that “forgetting” curve with a brief review would not only “reset” the curve, it would elongate the curve so later reviews wouldn’t be needed as often.
In a recent study, several groups of students attended learning sessions totaling 36 minutes of education time with a total 20 minutes of break time. The groups had their learning and break times broken up in different ways (massed vs. spaced learning) to compare who retained and performed better. The group that learned using short 12-minute lessons and 10-minute breaks in which they were actively involved in something else (not just a simple pause in teaching) retained and performed much better than their colleagues taught with standard massed-learning methods.
Just Another Brick in the Wall
One way to think of how this works is to picture making connections in learning like building a brick wall. Each brick is an important concept you want students to know and be able to retain and perform later. If you just keep piling up the bricks, you’re not going to end up with a good wall. Laying down a few bricks and giving the mental mortar time to set will help build a stronger, longer-lasting wall.
Spaced learning can be used with other evidence-based education techniques, especially spaced retrieval. These techniques can be leveraged by EMS educators in the classroom. For example, if you are educating EMT students, you may introduce a concept briefly in one session, then discuss other aspects of it in a later session, then utilize practice exercises with feedback later throughout the course. Can this add time and effort? Absolutely. But it can also help avoid those frustrating moments of students telling you they “never learned that” when you clearly remember the lecture.
Similarly, for continuing education, this gives educators the opportunity to not only help EMS providers ensure they are retaining recently taught information, it can also help ensure students don’t inadvertently fall back into old habits. Like many of the evidence-based education techniques we discuss here, a little extra planning and effort up front pays off in performance improvements and problem reductions for months and years to come.
Rommie L. Duckworth, LP, is a dedicated emergency responder and award-winning educator with more than 25 years working in career and volunteer fire departments, hospital healthcare systems, and public and private emergency medical services. He is currently a career fire captain and paramedic EMS coordinator.