EEG Marker Found to Predict Long-term Learning

In 2012 I began work as Associate Chief of Staff for Education at the Veterans Affairs Boston Healthcare System. In this job, I am responsible for the education of the more than 3,000 trainees who rotate through VA Boston each year, including those training to be physicians, nurses, psychologists, pharmacists, optometrists, podiatrists, physical and occupational therapists, speech-language pathologists, physician assistants, and nurse practitioners, among others.

As a researcher who has spent a career examining learning and memory in both healthy individuals and those with memory disorders, my first thoughts were: What can I do to improve learning across the medical center? Before I could get started, however, I realized that I needed to have an outcome to measure. I considered surveys of how much trainees either enjoyed their rotations or learned from them, but dismissed that idea, as enjoyment doesn’t necessarily correlate with learning success, and students’ impressions of how much they have learned are often grossly inaccurate. Testing the students on their knowledge seemed like the right thing, but I ran into another problem: one can perform well on a test during the course but not remember the information long-term. After cramming for a test, for example, a student may forget the majority of the information in a matter of weeks! In the healthcare professions, we need to make sure that the knowledge gained by trainees will last throughout their careers. It was for this reason that I began to look for a marker of long-lasting learning.

We started our exploration using a special type of EEG called an event-related potential (ERP). ERPs measuring EEG activity when a stimulus—such as a remembered word—appears on a computer screen. When you average across a bunch of items, the background EEG activity is averaged away, and you can actually see the brain activity related to remembering (or not remembering!) the item.

Red-orange region shows the brain area that predicts long-lasting learning.

Source: Andrew Budson

We recorded ERPs on medical students taking anatomy for the first time, measuring their responses to anatomical terms at three times: prior to the course, right at the end of the course, and—importantly—6 months later. For each term presented in the three sessions, the students reported whether they could define the term (confirmed later by a test), were familiar with the term or didn’t know it. We then sorted the ERP data obtained right at the end of the course for each individual term by their performance at the 6-month timepoint. We found a small region in the back of the left side of the brain, previously associated with detailed recollection of memory, that was actually able to predict whether the student could define the anatomic term 6 months in the future (see figure). This study was published in the Journal of Cognitive Neuroscience.

We are following up this preliminary finding with additional experiments to prove the validity and scope of this marker. We are hopeful that in the future this and other markers of long-lasting learning can be used to rapidly determine which educational techniques best engender education that will last for a lifetime.

© Andrew E. Budson, MD, 2019, all rights reserved.