Advances in Health Sciences Education

, Volume 20, Issue 4, pp 953–968 | Cite as

The mediating effect of context variation in mixed practice for transfer of basic science

  • Kulamakan KulasegaramEmail author
  • Cynthia Min
  • Elizabeth Howey
  • Alan Neville
  • Nicole Woods
  • Kelly Dore
  • Geoffrey Norman


Applying a previously learned concept to a novel problem is an important but difficult process called transfer. Practicing multiple concepts together (mixed practice mode) has been shown superior to practicing concepts separately (blocked practice mode) for transfer. This study examined the effect of single and multiple practice contexts for both mixed and blocked practice modalities on transfer performance. We looked at performance on near transfer (familiar contexts) cases and far transfer (unfamiliar contexts) cases. First year psychology students (n = 42) learned three physiological concepts in a 2 × 2 factorial study (one or two practice contexts and blocked or mixed practice). Each concept was practiced with two clinical cases; practice context was defined as the number of organ systems used (one system per concept vs. two systems). In blocked practice, two practice cases followed each concept; in mixed practice, students learned all concepts before seeing six practice cases. Transfer testing consisted of correctly classifying and explaining 15 clinical cases involving near and far transfer. The outcome was ratings of quality of explanations on a 0–3 scale. The repeated measures analysis showed a significant near versus far by organ system interaction [F(1,38) = 3.4, p < 0.002] with practice with a single context showing lower far transfer scores than near transfer [0.58 (0.37)–0.83 (0.37)] compared to the two contexts which had similar far and near transfer scores [1.19 (0.50)–1.01 (0.38)]. Practicing with two organ contexts had a significant benefit for far transfer regardless of mixed or blocked practice; the single context mixed practice group had the lowest far transfer performance; this was a large effect size (Cohen’s d = 0.81). Using only one practice context during practice significantly lowers performance even with the usually superior mixed practice mode. Novices should be exposed to multiple contexts and mixed practice to facilitate transfer.


Basic science Transfer Cognition Teaching strategies Instructional design 



We would like to thank Dr. Wei-Zhen Lee and the Program for Educational Research and Development at McMaster University for assistance with data collection.


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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Kulamakan Kulasegaram
    • 1
    Email author
  • Cynthia Min
    • 2
  • Elizabeth Howey
    • 3
  • Alan Neville
    • 5
  • Nicole Woods
    • 4
  • Kelly Dore
    • 3
  • Geoffrey Norman
    • 3
  1. 1.Department of Family & Community Medicine & The Wilson CentreUniversity of TorontoTorontoCanada
  2. 2.Centre for Health Education ScholarshipUniversity of British ColumbiaVancouverCanada
  3. 3.Programme for Education Research and Development, Faculty of Health SciencesMcMaster UniversityHamiltonCanada
  4. 4.Department of Surgery & The Wilson Centre, Faculty of MedicineUniversity of TorontoTorontoCanada
  5. 5.Department of Oncology, Faculty of Health SciencesMcMaster UniversityHamiltonCanada

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