3 Ways Using Context-Dependent Memory Can Improve Patient Outcomes
By: Nataliya Zlotnikov MSc, HBSc ∙ Estimated reading time: 5 minutes

Has this ever happened to you?

Has this ever happened to you? You demonstrated a home exercise program, had your patient try it out, provided corrections, made sure that they could feel the exercises, and felt pretty confident that they were going to perform the exercises correctly, only to have them come back for the next session performing something totally unrecognizable. 

Classic.

That’s context-dependent memory at work.

N.B. If you skip this whole blog because it's not a good day for reading, scroll down to the end of the blog to view our home exercise program blooper reel, featuring context-dependent memory. It may not be a good day for reading, but perhaps you could do with a laugh. 

Context-dependent memory subtypes

Context-dependent memory asserts that when you learn something in one context, it is easier to remember it in the same context (Smith and Vela, 2001). Subtypes of context-dependent memory include:

• Environmental: when we learn something in an environment, it will be easier to recall that learned information in the same or similar environment; this is the classic context-dependent memory subtype that comes to mind when we think of context-dependent memory (Vinney, 2021). A classic example is the 1975 Godden and Baddeley experiment. in which divers learned words on land or underwater. They were later tested on recall in the original and alternate learning environments. The researchers found that words learned on land were best recalled on land, while words learned underwater were best recalled underwater.
   
• State-dependent: learning something in a specific physical or mental state will facilitate later recall in the same mental or physical state (Vinney, 2021).
  
  
• Cognitive: this subtype is based on the cognitive state that a person is in when learning and remembering. The two main states that have been studied are language and motivational states. For bilingual people or polyglots, learning something in one language leads to recalling it most effectively in the same language. When thinking of achievement, learners are more likely to recall words and information learned at that time (Vinney, 2021).
  
  
• Mood: in mood-dependent memory, subjects can better recall information if the mood is the same at encoding and recall (Vinney, 2021). In addition, positive mood at encoding has been linked with improved recall (Lee and Sternthal, 1999).

As a clinician or clinic owner, by now you might be thinking, 'Hmmnn, interesting, how can I apply context-dependent memory to my practice?'

We were wondering the same thing, and after some brainstorming, we came up with 3 ideas that we discuss below. 

1. Record your patients performing their exercises 

When you record your patient performing their prescribed home exercise program and share that exercise with them, they can imagine themselves in the environment where they learned it, i.e., your office, without having to be there physically. With that, we can see fewer errors in exercise execution and improved clinical outcomes. 

This feature is available on Embodia as part of our Tier 2 and Tier 3 memberships. You can learn more about the ability to record your patients in session in the help article, Record a patient doing an exercise or watch our video tutorial below!

2. Show prescribed home exercise videos in session

You might not be able to re-create your clinic environment at home, but you can add some clinic elements into their at-home practice. And no, you do not have to give everyone a pen from your clinic each time they visit you, instead, allow some time in your appointment to view (and try) the exercise videos that you plan to prescribe, to increase retention and decrease errors. 

You can do this using Embodia's HEP! Learn more about HEP on Embodia here, or watch our video tutorial!

3. Help patients improve their mood during sessions, or at least don't make it worse 

Stress disrupts context-dependent memory (Schwabe, Böhringer and Wolf, 2009). When we are in a good mood, we can retain and remember more information. Do patients appear stressed in your practice? Or are they relaxed? Some things you can try to help patients feel more relaxed and by extension retain information include: 

• Help patients relax: make sure to listen actively and let your patients share openly, to make them feel more comfortable and heard. You can also try a short meditation with your patients before teaching them an exercise. There are many available on Embodia for you to use! 
  
  
• Don't stress the retention: do not make the learning and retention feel overwhelming, for example, do not make patients feel that they have to remember everything in the exercise, as you will record them and share videos with them, for example. 
  
  
• Don't overteach: we don’t mean that you should skip the meat and potatoes. What we mean is skipping what people will forget. Research shows that 40-80% of the medical information provided by healthcare practitioners is forgotten immediately (Kessels, 2003), therefore we should avoid sharing too much, and focus on providing just the key information. You can also use Embodia's two-way messaging to securely share any additional information with your patients.   
  
  
• Stop thought viruses: thought viruses are "unconscious thought patterns that distort our thinking and perception of the world" (Lofland, 1997) and can further contribute to negative moods. Lorimer Moseley suggests 3 steps to stop thought viruses, challenge a concept, provide an alternative concept, and provide evidence for a new concept. You can learn more about thought viruses in Dr. Erson Religioso III's online healthcare course on Embodia, Integrating Manual Therapy and Patient Education: Transform Passive Care into Active Care and more about approaches to pain education in the course, The Eclectic Approach to Modern Patient Education. 
  
  

Learn more with Dr. Andrew Rothschild
and Dr. Erson Religioso III
 

These are a few of the ideas we were able to come up with to apply context-dependent memory in our practice to help patients learn and execute home exercise programs better; can you think of any more? We'd love to hear about them! So don't hesitate to reach out and tell us about your great ideas!

Context-Dependent Memory Bloopers

The Embodia team regularly records new exercises to add to our library. Sometimes, we end up with something like this...a perfect example of context-dependent memory!

Learn more about home exercise programs on Embodia here, or book a time to meet with us to learn more about Embodia's HEP or Practice Management features. 

Meet with us! 

References: 

Godden, D.R., and Baddeley A.D. (1975). Context-Dependent Memory in Two Natural Environments: On Land and Underwater. British Journal of Psychology, 66(3), 325-331. https://doi/10.1111/j.2044-8295.1975.tb01468.x. 

Lee, A.Y., and Sternthal, B. (1999). The Effects of Positive Mood on Memory. Journal of Consumer Research, 26(2), 115-127. https://doi.org/10.1086/209554. 

Lofland, D. (1997). Thought Viruses: Powerful Ways to Change Your Thought Patterns and Get What You Want in Life. Three Rivers Press (CA).

Schwabe, L., Böhringer, A., and Wolf, O.T. (2009). Stress disrupts context-dependent memory. Learning & Memory, 16(2), 110–113. https://doi.org/10.1101/lm.1257509 

Vela, E., and Smith, S.M. (2001). Environmental Context-Dependent Memory: A Review and Meta-Analysis. Psychonomic Bulletin & Review, 8 (2), 203-220. https://doi.org/10.3758/BF03196157.

Vinney, C. (2021). How Context-Dependent Memory Works. Retrieved 3 December 2023 from https://www.verywellmind.com/how-context-dependent-memory-works-5195100.

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Published: 6 Dec 2023
Last updated: 5 July 2024