RESEARCH ARTICLE Open Access Does The Mind Map Learning .
D’Antoni et al. BMC Medical Education 2010, ESEARCH ARTICLEOpen AccessDoes the mind map learning strategy facilitateinformation retrieval and critical thinking inmedical students?Anthony V D’Antoni1,2*, Genevieve Pinto Zipp1, Valerie G Olson1, Terrence F Cahill1AbstractBackground: A learning strategy underutilized in medical education is mind mapping. Mind maps are multisensory tools that may help medical students organize, integrate, and retain information. Recent work suggeststhat using mind mapping as a note-taking strategy facilitates critical thinking. The purpose of this study was toinvestigate whether a relationship existed between mind mapping and critical thinking, as measured by the HealthSciences Reasoning Test (HSRT), and whether a relationship existed between mind mapping and recall of domainbased information.Methods: In this quasi-experimental study, 131 first-year medical students were randomly assigned to a standardnote-taking (SNT) group or mind map (MM) group during orientation. Subjects were given a demographic surveyand pre-HSRT. They were then given an unfamiliar text passage, a pre-quiz based upon the passage, and a30-minute break, during which time subjects in the MM group were given a presentation on mind mapping. Afterthe break, subjects were given the same passage and wrote notes based on their group (SNT or MM) assignment.A post-quiz based upon the passage was administered, followed by a post-HSRT. Differences in mean pre- andpost-quiz scores between groups were analyzed using independent samples t-tests, whereas differences in meanpre- and post-HSRT total scores and subscores between groups were analyzed using ANOVA. Mind map depth wasassessed using the Mind Map Assessment Rubric (MMAR).Results: There were no significant differences in mean scores on both the pre- and post-quizzes between notetaking groups. And, no significant differences were found between pre- and post-HSRT mean total scores andsubscores.Conclusions: Although mind mapping was not found to increase short-term recall of domain-based informationor critical thinking compared to SNT, a brief introduction to mind mapping allowed novice MM subjects toperform similarly to SNT subjects. This demonstrates that medical students using mind maps can successfullyretrieve information in the short term, and does not put them at a disadvantage compared to SNT students. Futurestudies should explore longitudinal effects of mind-map proficiency training on both short- and long-terminformation retrieval and critical thinking.BackgroundThe amount of information that medical students areexpected to master is voluminous[1]. Yet, there are limited learning strategies available to these students tomaster the volume of information required to succeed* Correspondence: adantoni@nycpm.edu1Department of Graduate Programs in Health Sciences, School of Health andMedical Sciences, Seton Hall University, 400 South Orange Avenue, SouthOrange, NJ 07079, USAFull list of author information is available at the end of the articlein medical school[2]. In recent years, the number ofpublications on learning strategies used in medical education that may help students learn and ultimately integrate information has increased[3-6]. Although theselearning strategies may differ in efficacy and applicability, they are all based on a conceptual framework calledthe constructivist theory of learning, which states thatmeaningful learning, or learning with understanding,occurs when adult learners assimilate new informationwithin their existing frameworks[7,8]. 2010 D’Antoni et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited.
D’Antoni et al. BMC Medical Education 2010, onstructivist theory is rooted in the subjectivistworldview, which emphasizes the role of the learnerwithin the context of his environment[9]. The interaction between the learner and his environment results inmeaning or understanding; therefore, the two are inextricable[9]. Many learning strategies, such as case-basedlearning and PBL, assume the learner is committed tolifelong learning and will integrate previous knowledgewith newly acquired knowledge[10,11].The theoretical basis of constructivism is depicted inFigure 1. In medical school, academic information isavailable to the medical student through reading, visualizing, or listening. Irrespective of the mechanism, information enters the mind of the student, who is activelytrying to make sense of the information. Because thesensemaking of the student may be very different fromthat of the professor presenting the information,[12] oneof the assumptions underlying constructivist theory isthat the student will integrate the information into apersonal framework so that it will be retained,[8] whichresults in meaningful learning.Page 2 of 11[13,14]. How critical thinking should be taught and howit is learned are unclear,[15,16] especially at the medicalschool level. Willingham[15] stated that critical thinkingoccurs when a student penetrates beyond the surfacestructure of a problem and recognizes how the problemcan be solved, and in addition, possesses the contentknowledge integral to solving the problem. Withoutboth components, a student may be able to criticallyanalyze one problem, but will falter when given a similarproblem in a different context[15]. Graduating physicians should be able to critically evaluate novel casesthat they encounter in the clinic using their previous,albeit limited, clinical experiences[17].Concept mapping in medical educationIn graduate medical education, West et al[17] used theconcept map learning strategy developed by JosephNovak[18] in resident physicians, and studied the validity and reliability of concept mapping assessment(CMA). They found that concept maps could be scoredreliably and CMA could measure changes in the conceptual framework of physicians[17].Critical thinkingMeaningful learning is necessary for critical thinking.The operational definition of critical thinking is a metacognitive, nonlinear process of purposeful judgment thatincludes self-directed learning and self-assessmentMeaningful iesSocialcontextExistingframeworkLearner’s mindReading informationHearing informationVisualizing informationFigure 1 Constructivist theory of learning. Theoreticalassumptions that underlie constructivist theory using a bottom-upapproach. Academic information is commonly available to thelearner through reading, visualizing, or listening. Irrespective of themechanism, information enters the mind of the learner, who isactively trying to make sense of the information. Adapted fromAusubel [7].Mind mapping in medical educationMind mapping was developed by Tony Buzan[19] andthe inspiration for this strategy arose from the notebooks of Leonardo da Vinci[20]. Mind maps, like daVinci’s notes, are multi-sensory tools that use visuospatial orientation to integrate information, and consequently, help students organize and retain information[21,22].Mind maps can be used as a teaching tool to promotecritical thinking in medical education by encouragingstudents (adult learners) to integrate informationbetween disciplines and understand relationshipsbetween the basic and clinical sciences[21]. The abilityto integrate information by finding valid relationshipsbetween concepts allows students who construct eithermind maps or concept maps to reach a metacognitivelevel[15]. However, the added dimensions of picturesand colors that are unique to mind maps have not onlybeen shown to facilitate memory,[23] but may appeal toa wide range of students withvisual- and linear-orientedlearning styles. Consequently, the advantage of usingmind maps in medical education is that this strategymay benefit more students with diverse learning styles.Both mind maps and concept maps allow students torecognize the intra- and inter-relationships betweenconcepts, which reflects the kind of real-world thinkingpredominant in the clinical setting[24].Farrand et al[25] were the first group to investigatethe potential role of mind mapping in medical education. These researchers explored whether the mind maplearning technique was superior to traditional note
D’Antoni et al. BMC Medical Education 2010, age 3 of 11relationships between concepts[25]. Currently, however,there are no data to support the hypothesis that mindmaps facilitate critical thinking in medical students.taking in both short- and long-term factual recall ofwritten information in medical students. They foundthat the mind map technique significantly improvedlong-term memory of factual information. Additionally,they found significant differences in self-reported motivation with the mind map group having lower levels ofmotivation than the self-selected study group. Althoughnot supported by other literature, this finding may beexplained by the fact that students were not given adequate time to adjust to using the mind map technique,and therefore, may have felt less comfortable using it.Although the results of the study were promising, theauthors did not address critical thinking. Consequently,studies exploring the relationship between mind mapping and critical thinking are needed before the usefulness of mind mapping can be fully supported in medicaleducation.Wickramasinghe et al[26] were the second group toinvestigatethe effectiveness of mind maps in medicaleducation. Using a similar study design as that used byFarrand et al,[25] these authors assigned new entrymedical students into 2 groups: mind map and selfselected study groups. The authors also developed amethod to score the mind maps based on structure andcontent; however, they did not describe the method nordid they provide any data to support it[26]. The authorsreported that there was no significant difference inscores between groups[26]. They did, however, reportthat all of the subjects in the mind map group perceivedthat mind maps are useful for memorizing information.Based on their findings, the authors concluded thatmind mapping may not be effective in improving retention of short-term information[26].After full approval by an Institutional Review Board, thisstudy was conducted during the 2008-2009 academicyear at a US medical school located in a large metropolitan area.An a priori power analysis[29] using a one-tailed t-testrevealed a minimum sample size of 70 subjects. Thiscalculation was based on the following: effect size d 0.8, alpha 0.05, and power 0.95. The large samplesize (N 131) assumes a normal distribution of thepopulation, and therefore, parametric statistics wereused to analyze the data. The sample of convenienceconsisted of first-year medical students who voluntarilyparticipated in this study.Mind maps and concept mapsProceduresAlthough concept maps and mind maps have similarcharacteristics, they are fundamentally different indesign. Concept maps are devoid of color and pictures,and are constructed in a top-to-bottom hierarchy. Mindmaps, in contrast, use a central theme in the middle ofa page with categories and subcategories that radiateperipherally, thus making them truly non-linear. Thecross-links among categories highlight their intrinsicrelationships, and allow the student to compare andcontrast information. Unlike concept maps, mind mapsare multisensory–they include color and pictures, whichfacilitate the conversion of information from short- tolong-term memory[23,27]. An example of a mind mapcreated by a medical student in this study can be foundin Figure 2.Since critical thinking is dependent upon both content(domain) knowledge and problem familiarity,[15] mindmapping may facilitate critical thinking because it fosters student retention of factual information, as well asThe independent variable in this study was the note-taking strategy used by the medical students. Subjects wererandomly assigned to 2 note-taking groups: a standardnote-taking (control) group and mind map (experimental) group. The design of the study is outlined in Figure 3.Subjects in both note-taking groups were asked to learninformation contained in a 394-word text passage—onthe topic of cacti and other succulent plants—from theverbal ability section of a previously published GraduateRecord Examination (GRE). This topic was chosen toreduce the chance that the medical students would haveprevious advanced knowledge of this field. The GRE is astandardized entrance examination used as part of theUS graduate-school admissions process. The exam isused by faculty to decide which students will be admittedto graduate school and who will be awarded academicfellowships. A GRE text passage was used in this studybecause the GRE is taken by students who are, in general,of a similar age to those entering US medical schools.Purpose of the studyThe primary purpose of this study was to investigatewhether a relationship existed between the mind maplearning strategy and critical thinking, as measured withthe Health Sciences Reasoning Test (HSRT), andwhether this relationship was stronger than one betweenthe preferred learning strategy of standard note-taking(SNT) and critical thinking.The secondary purpose of this study was to determinewhether mind maps were superior to SNT in the shortterm recall of factual information. Mind map depth wasassessed using the previously published Mind MapAssessment Rubric[28].MethodsStudy setting and sample
D’Antoni et al. BMC Medical Education 2010, age 4 of 11Figure 2 Student mind map. An example of a mind map from one of the medical students in this study. Note the judicious use of picturesand colors, along with hierarchical organization positioned radially. Note how different colors were used to indicate different hierarchies (eg,green is primary hierarchy, blue is secondary, aqua is tertiary, etc.). In addition to the above example, other student mind maps have beenpublished elsewhere[22,28].Consequently, the text passage was at an appropriatecognitive level for medical students. A post hoc analysisof the medical students in the study revealed that none ofthem majored in botany at the undergraduate level.Subjects in the control group used standard notetaking (SNT) strategies that they used throughout theiracademic careers to learn the text passage. SNT isdefined as any study strategy that does not rely onreorganizing information using architecture commonlyseen in a concept map or mind map[25]. SNT is a process whereby notes are arranged in a hierarchy fromthe top of a page to the bottom, or from left to right,without any hierarchy[30]. Subjects in the experimental(mind map) group were given a 30-minute presentation on mind maps and then instructed to create mindmaps in order to take notes on the material in the textpassage.There were two dependent variables in this study.The first one was the score on the text passagequiz, of which there were two. These two quizzes,which were based on the content of the GRE textpassage, were administered to all subjects afterassignment to the groups. All subjects were simultaneously (but in different rooms) exposed to the passage for 5 minutes and were not permitted to writeany notes. The passage was collected and followedby the administration of math quiz 1. This quiz wasused to “blank” the minds of the subjects by preventing the simple recall of information that couldresult in a higher quiz score and confound theresults[25].After math quiz 1, all subjects were administered textpassage quiz 1. The purpose of this 5 multiple-choicequestion quiz was to test the students’ factual understanding of the passage without any note-taking strategy.This baseline quiz was used as a covariate to account forpotential differences between the groups prior to initiating any note-taking strategy.
D’Antoni et al. BMC Medical Education 2010, age 5 of 11Figure 3 Study design. Research procedure.After taking text passage quiz 1, subjects in the mindmap group were given a presentation on mind mapsand how to construct them, while at the same time, subjects in the control group were sequestered for a breakand could not leave the lecture hall. After 30 minutes,all subjects were then re-exposed to the text passageand instructed to take notes using either standard notetaking (SNT) or mind maps (MMs), depending on theirgroup assignment. All subjects were given 25 minutesfor note-taking and at the end of this time period, allpassages and notes were collected. This was followed bythe administration of math quiz 2 in order to again discourage the simple recall of information by the subjects.After math quiz 2, all subjects were simultaneouslyadministered text passage quiz 2 based upon the passage. This quiz consisted of 10 multiple-choice questions: the same 5 questions from quiz 1 plus anadditional 5 questions. This was done to see if the students retained the factual information and to addresspotential testing effects (ie, higher scores due torepeated testing exposure).The second dependent variable of this study was theHSRT score. The HSRT consists of 33 multiple-choicequestions that measure critical thinking by challengingstudents to form reasoned judgments based on textuallypresented information consisting of a number of vignettes[31]. The information presented in the vignettesincludes diagrams, charts, and other data related tohealth care scenarios. The HSRT does not test domainknowledge (ie, subject-specific knowledge such as thatfound in anatomy and biochemistry); therefore, subjectspecific knowledge is not needed by the students takingthe exam. The HSRT has been extensively studied inhealth professional students and working professionals[14,31].The HSRT reports an overall numerical score and 5subscales: analysis, inference, evaluation, deductive reasoning, and inductive reasoning. The operational definitions of these subscales, adapted from a previous Delphistudy, [14] follow: analysis (ability to identify theintended and actual inferential relationships amongstatements, questions, concepts, descriptions or otherforms of representation intended to express beliefs,judgments, experiences, reasons, information or opinions); inference (ability to identify and secure elementsneeded to draw reasonable conclusions; to form conjectures and hypotheses, to consider relevant informationand to educe the consequences flowing from data, statements, principles, evidence, judgments, beliefs, opinions,concepts, descriptions, questions, or other forms ofrepresentation); evaluation (ability to state the results ofone’s reasoning; to justify that reasoning in terms of theevidential, conceptual, methodological, criteriologicaland contextual considerations upon which one’s results
D’Antoni et al. BMC Medical Education 2010, ere based; and to present one’s reasoning in the formof cogent arguments); deductive reasoning (assumedtruth of the premises purportedly necessitates the truthof conclusion and this includes traditional syllogisms, aswell as, algebraic, geometric, and set-theoretical proofsin mathematics); and inductive reasoning (an argument’sconclusion is purportedly warranted, but not necessitated, by the assumed truth of its premises and thisincludes scientific confirmation and experimental disconfirmation)[31].Mind maps were scored using the Mind Map Assessment Rubric (MMAR). The interrater reliability of theMMAR is strong and has been reported to be 0.86[28].Face validity of the MMAR has been investigated, andthe entire rubric is
Mind mapping in medical education Mind mapping was developed by Tony Buzan[19] and the inspiration for this strategy arose from the note-books of Leonardo da Vinci[20]. Mind maps, like da Vinci’s notes, are multi-sensory tools that use visuospa-tial orientation to integrate information, and conse-quently, help students organize and retain .
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