Professional Documents
Culture Documents
Manuscript ID QJE-STD-20-176.R5
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Correspondence concerning this article should be addressed to Dr Conal Twomey, Clinical
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30 Psychologist, Health Service Executive, Adult Mental Health Services, Ballyfermot &
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32 Palmerstown Primary Care & Mental Health Centre, Ballyfermot Road, Dublin 10, Ireland
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34 Contact: conal.twomey@hse.ie
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demonstrated the effectiveness of the loci method as a mnemonic device, with a medium
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22 effect size (g = 0.65, 95% CI: 0.45–0.85; I2 = 45.5%). The effect size remained at similar
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24 levels in further analyses adjusting for publication bias, the impact of removing each study,
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26 setting, control conditions, outliers, and number of loci method sessions. High risk of
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experimental bias was indicated, however, as the vast majority of studies did not report
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31 procedures to minimise biases relating to random sequence generation and allocation
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38 encourage future investigations and applications, particularly in educational settings, where it
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45 Keywords: meta-analysis, mnemonic, memory, loci
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buildings, trees, or rooms); (3) creating imagery for each to-be-remembered item (e.g. a
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22 person); (4) linking each item to one of the landmarks; (5) for recall, imagining the journey,
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24 observing the items at each landmark along the route. It is thought that the loci method relies
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31 regions (Caplan, Legge, Cheng, & Madan, 2019; Dresler et al., 2017; Maguire et al., 2003);
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33 however, the method also appears to incorporate general mnemonic devices such as effortful
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attention, memory for emotion, organisation, linking, chunking, and elaboration (Bellezza &
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38 Reddy, 1978; Caplan et al., 2019; Carney, Levin, & Levin, 1994; McCabe, 2015; Restorff,
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45 The origins of the loci method – also referred to as the memory journey, the mental walk, and
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47 the memory palace – can be traced to hunter-gatherer societies (Kelly, 2015); however, the
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49 method is commonly attributed to the Greek poet Simonides of Ceos (556–468 BC) who (a)
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52 identified the bodies of fellow banquet guests killed by a building collapse using his memory
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54 of their seating allocations and (b) later formalised the loci method based on this experience
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56 (Yates, 1966). The loci method has been continually used in virtually unchanged format for
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thousands of years, demonstrating its longevity and utility (Maguire et al., 2003). In recent
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Aside from the above feats of memory, the loci method has frequently been used in
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22 combination with other mnemonic devices in multi-faceted memory training programmes for
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24 older adults and people with cognitive impairment (Gross et al., 2014; Gross et al., 2012;
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26 Hudes, Rich, Troyer, Yusupov, & Vandermorris, 2019; Verhaeghen, Marcoen, & Goossens,
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1992; Wolgemuth, Cobb, & Alwell, 2008; Yang et al., 2018). However, there have been
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31 relatively few direct applications of the loci method within clinical and educational settings
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33 (Dalgleish et al., 2013; McCabe, 2015). While age, cognitive functioning, health status and
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other demographics may interfere with clinical applications of the loci method (Rebok et al.,
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38 2013), these factors are unlikely to be as important in educational settings. It is therefore
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40 puzzling that the loci method is not more widely used by students, especially since the
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expected enhancement of information recall would likely aid exam performance (McCabe,
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45 2015).
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49 A potential reason for the few practical applications of the loci method relates to the lack of
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52 high-quality studies directly investigating its effectiveness. Many observational and quasi-
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54 experimental studies have been conducted across several decades – with generally favourable
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56 results (Cornoldi & De Beni, 1991; Dresler et al., 2017; Groninger, 1971; Gross et al., 2012;
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Lea, 1975; Maguire et al., 2003; McCabe, 2015; Ross & Lawrence, 1968), and a 1992 meta-
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future practical and research applications.
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other mnemonic devices, RCTs which examined the effectiveness of the loci method in
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22 combination with other mnemonic devices, and RCTs with the loci method incorporated as
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24 part of all control conditions. No limits were set according to study outcome, status, or
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31 Literature search and data extraction
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33 Search terms relating to the loci method (i.e. loci method OR loci system OR journey* OR
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palace) were combined with words relating to memory (i.e. memory* OR remember* OR
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38 retrieval OR recall OR mnemo* OR mind) and RCTs (i.e. random* OR control* OR
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40 experimental OR RCT). It is worth noting that the trialled search term ‘method of loci’ did
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not return additional search results (owing to its similarity to the term ‘loci method’) and it
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45 was therefore not included. PsycINFO, ERIC, MEDLINE, and Academic Search Premier
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47 comprised the databases, last searched on 22/09/20. Additional records were identified
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49 through hand-searching of reference lists of included studies. The first author screened all
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52 abstracts and the second author independently screened 50% of abstracts. When we disagreed
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54 regarding the screening outcome of an abstract, it was included in screening at
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56 ‘full-text’ level, which was subsequently conducted by the first author. Data were managed
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using EndNote X7 (Thomson Reuters Corp.,) and word processing software. Extracted data
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& Deeks, 2011). All statistical analyses were performed using Comprehensive Meta-Analysis
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22 (version 2.0, Biostat Inc.). Pooled mean effect sizes (Hedges’ g) with 95% confidence
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24 intervals (CI) were calculated; effect sizes of 0.2, 0.5 and 0.8 refer to small, moderate and
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26 large effect sizes respectively (Cohen, 1988). All effect sizes were automatically calculated
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using Comprehensive Meta-Analysis; means (and standard deviations) and sample sizes for
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31 the intervention and control groups comprised the requisite data for the automated effect size
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33 calculations, and these data were independently extracted by the authors, before being cross-
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checked. Higgin's I2 percentages interpreted the heterogeneity of effect sizes; scores of 25%,
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38 50% and 75% indicate low, moderate and high heterogeneity, respectively (Higgins &
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40 Thompson, 2002). Higgin’s I2 has less precision in relatively small meta-analysis such as the
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current one; therefore, two additional heterogeneity statistics were calculated: Cochran’s Q
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45 (Cochran, 1950) and τ2 (Higgins, 2008). The former provides a more conservative estimate
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47 of heterogeneity based on statistical significance; the latter represents the among-study
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49 variance of the true effect sizes. Data from the final post-intervention data collection point
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52 were analysed, reflecting the practical need for mnemonic devices to be effective for a period
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54 of time (Higbee, Clawson, Delano, & Campbell, 1990). This data was extracted and cross-
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56 checked by the study’s two authors, with any discrepancies resolved through discussion. To
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avoid double-counting (Senn, 2009), the effects of different intervention arms representing
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Davey Smith, Schneider, & Minder, 1997). Three sensitivity analyses were conducted: (1) a
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22 one-study-removed analysis (Comprehensive Meta-Analysis (version 2.0, Biostat Inc.)
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24 computed pooled effect sizes when each study was removed from the meta-analysis,
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26 therefore illustrating the impact of each study on the primary pooled effect size; (2) a meta-
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analysis wherein the only two studies with non-student samples were excluded; (3) a meta-
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31 analysis that removed outliers identified through visual inspection of the forest plot. Finally,
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33 two-moderator analyses were conducted: (1) a comparison of pooled effect sizes from studies
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with ‘active’ and ‘no instruction’ control conditions (a more nuanced control condition
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38 comparison would have been at the expense of limited available statistical power); (2) a
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40 meta-regression with the number of loci method training sessions as a predictor of the effect.
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45 Risk of bias assessment
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47 In line with previous meta-analyses conducted by the first author and colleagues (BLINDED
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49 REFERENCES), three criteria from the Cochrane Collaboration's tool for assessing risk of
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52 bias (Higgins & Green, 2011) were deployed: random sequence generation, allocation
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54 concealment and completeness of outcome data. For random sequence generation, a low risk
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56 of bias is present when a random component in the process of generating the order of
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participant allocations to experimental or control conditions is reported (e.g. using a
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% of missing data (<20% is considered a low risk in RCTs with a short-term follow up) and
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22 whether or not this is related to the outcome, and balanced across experimental conditions.
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24 When procedures in relation to minimising the above potential biases are not reported in the
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26 published manuscript of a given study, the risk level can be adjudged “unclear”; however, a
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high risk of bias is also commonly adjudged in these cases, to promote greater caution in
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31 relation to the interpretation of findings (Twomey, O'Reilly, Bultmann, & Meyer, 2020). The
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33 latter stance was taken in the current study: if procedures to minimise a bias were not
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reported in a study’s manuscript, a high risk of bias was marked. Separate risk of bias
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38 assessments were conducted by this study’s authors; discrepancies were discussed and
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40 resolved.
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47 Results
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49 Study selection and characteristics
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52 1,326 records were screened and 16 studies were selected for review, with both authors
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54 agreeing that 82.3% of independently screened abstracts should be subsequently examined at
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56 ‘full-text’ level (note that all of the disputed selections – the 17.7% remaining abstracts -
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were also subsequently examined at ‘full-text’ level). However, only 13 studies could be
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Plunnecke, 2006; Qureshi, Rizvi, Syed, Shahid, & Manzoor, 2014; Weinstein et al., 1981).
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22 Publication dates ranged from 1971 – 2016, the majority of studies were set in United States
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24 or European universities, and there were a variety of recruitment procedures. Sample sizes
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26 ranged from 34-142 (combined N=1244), the majority of studies had mostly female
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participants, and mean ages ranged from 19-70. Simple instructions were used for loci
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31 method training in most studies, though training sessions (of varying number) were also
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33 provided in some studies. Word recall comprised the relevant outcome in all-but-two studies;
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outcomes were mostly assessed on the same day as the RCT experiment. Dropout was zero in
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38 all-but-two studies: (1) a community-based study with a two week follow-up period: 16% of
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40 loci method participants dropped out (Dalgleish et al., 2013); (2) another community-based
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study with a 9 week follow-up period: 9% of controls dropped out (Engvig et al., 2010) .
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45 Finally, as indicated in Table 1, risk of bias studies was high: although dropout was
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47 invariably minimal, the vast majority of studies did not document procedures to minimise
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49 biases relating to random sequence generation and allocation concealment. It is worth noting
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52 that, based on independent evaluations, the authors agreed on 46 out of the 48 risk of bias
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54 ratings across the 16 studies (95.8% agreement rate), and upon further discussion they agreed
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56 upon the final two ratings.
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The effectiveness of the loci method as a mnemonic device
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22 As per the forest plot (Figure 2), comparisons from 13 studies demonstrated the effectiveness
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24 of the loci method as a mnemonic device, with a medium effect size (g = 0.65, 95% CI: 0.45–
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26 0.85) and moderate heterogeneity that was statistically significant (I2 = 45.5%; τ2 = 0.06, SE =
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0.056; Cochrane’s Q = 22.03; p < 0.05). Publication bias was indicated by asymmetry in the
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31 funnel plot (Figure 3), a moderate correlation in the rank correlation test (τ = 0.34; p < 0.05)
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33 and a significant Egger’s regression intercept (B0 = 3.73, p < 0.05). The publication bias was
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handled using the ‘Trim and Fill’ procedure (Duval & Tweedie, 2000) which resulted in a
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38 slight reduction in the effect size (g = 0.55, 95% CI: 0.31–0.78). The results from the one-
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40 study-removed analysis are displayed in Figure 4; adjusted pooled effect sizes remained in
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the medium range (ranging from 0.58 to 0.69), indicating that the overall pooled effect size is
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45 only minimally impacted upon by the removal of any individual study. The sole inclusion of
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47 university-based studies in the meta-analysis also produced a medium effect size (g = 0.64,
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49 95% CI: 0.39–0.90). When two outliers identified in the forest plot (the first study from
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52 Kroneisen & Makerud, 2017 and the final study from de Beni et al., 1997) were removed the
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54 effect size decreased slightly but remained in the medium range (g = 0.53, 95% CI: 0.38–
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56 0.68) and heterogeneity was eliminated (I2 = 0%; τ2 = 0.00, SE = 0.030; Cochrane’s Q = 8.92;
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p > 0.05). Although moderator analyses were restricted by the relatively small number of
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This meta-analysis of 13 RCTs demonstrated the effectiveness of the loci method as a
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22 mnemonic device, with a medium effect size (g = 0.65, 95% CI: 0.45–0.85) that remained at
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24 similar levels in further analyses adjusting for publication bias, the impact of removing each
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26 study, setting, outliers, control conditions, and number of loci method sessions. Interpretive
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caution is warranted, as the findings are based on relatively small number of predominantly
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31 university-based studies. It is worth noting that in the sensitivity analysis that adjusted for
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33 (two) outliers with very large effect sizes, the effect size remained in the medium range and
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(previously moderate) heterogeneity was eliminated; the reasons for the very large effect
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38 sizes in the outliers are unclear as several of their characteristics - sample sizes,
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40 demographics, cognitive ability levels, loci training conditions, follow up periods, control
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conditions, and risk of bias levels - are similar to the other studies; moreover, the larger effect
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45 sizes could merely be a consequence of sampling error.
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49 In other reasons for interpretative caution, most reviewed RCTs had a ‘same-day’ follow up,
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52 which limits the generalisability of the findings, and is incongruent with the practical need for
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54 mnemonic devices to be effective for a period of time (Higbee et al., 1990). Furthermore, a a
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56 cumulative picture of high risk of bias was indicated across the included studies and this
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should be taken into account. More specifically, while there was good completeness of data
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22 The yielded support for the loci method is in line with findings from a 1992 meta-analysis of
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24 studies of varying design supporting the effectiveness of the loci method for older adults,
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26 with a large effect size yielded for a within-groups pre-to-post analysis (d = 0.80)
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(Verhaeghen et al., 1992). The slightly lower effect size in the current study may be
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31 attributable to its sole inclusion of RCTs – which provide a more stringent examination of
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33 cause-and-effect relaitonships (Sibbald & Roland, 1998) – and its focus on a between-groups
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analysis that directly compared the loci method with control conditions. The yielded support
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38 for the loci method is also in line with its documented use in feats of memory (Dresler et al.,
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40 2017; Hu et al., 2009; Maguire et al., 2003; Raz et al., 2009), findings from meta-analyses
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demonstrating the effectiveness of heterogeneous mnemonic devices for older adults (Gross
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45 et al., 2012; Hudes et al., 2019; Verhaeghen et al., 1992) and people with cognitive disorders
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47 (Yang et al., 2018), and findings from a systematic review supporting the effectiveness of
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49 heterogeneous mnemonic devices for youth with learning disabilities (Wolgemuth et al.,
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52 2008). What sets the current meta-analysis apart from these previous reviews is its sole
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54 inclusion of RCTs, its direct focus on the loci method which offers greater precision, and –
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56 owing to the sample compositions of included studies – the ability to generalise the findings
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students (McCabe, Osha, Roche, & Susser, 2013) and the considerable effort involved in
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22 mastering the loci method (Gross et al., 2014), would also need to be overcome for
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24 widespread educational use. The findings offer less support for the clinical application of the
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26 loci method, as only one included study had a clinical sample: individuals with depression
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(Dalgleish et al., 2013). However, the justification of the loci method’s use in this study - to
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31 construct an accessible mental repository for positive, self-affirming memories in order to
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38 1991), and this should be addressed in future research.
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Given the longevity of the loci method in popular culture (Maguire et al., 2003), it is
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45 surprising that relatively few studies were identified in this paper’s systematic literature
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47 research, and furthermore, that the review did not identify more RCTs with a low risk of bias.
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49 Although there exist several quasi-experimental and observational investigations of the loci
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52 method (Cornoldi & De Beni, 1991; Dresler et al., 2017; Groninger, 1971; Gross et al., 2012;
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54 Lea, 1975; Maguire et al., 2003; McCabe, 2015; Ross & Lawrence, 1968), there is a pressing
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56 need for more methodologically rigorous RCTs. Such RCTs would particularly benefit from
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longer follow-up periods: as mentioned above most reviewed RCTs had a ‘same-day’ follow
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In conclusion, this meta-analysis of a relatively small number of predominantly university-
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22 based RCTs has provided good initial support for the loci method as mnemonic device and
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24 this may encourage future investigations and practical applications, particularly in
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26 educational settings. The loci method appears to have been useful to humans since hunter-
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gather times (Kelly, 2015), yet there is still much to be explored and learned for its utility to
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31 be maximised in today’s society.
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22 Supplementary Material
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24 The Supplementary Material is available at: qjep.sagepub.com
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enhancing memory of psychology. Teaching of Psychology, 21(3), 171-174. doi:
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22 Cochran, W. G. (1950). The Comparison of Percentages in Matched Samples. Biometrika,
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26 Cornoldi, C., & De Beni, R. (1991). Memory for discourse: Loci mnemonics and the oral
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presentation effect. Applied Cognitive Psychology, 5(6), 511-518. doi:
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30 Crovitz, H. F. (1971). The capacity of memory loci in artificial memory. Psychonomic
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37 De Beni, R., Mò, A., & Cornoldi, C. (1997). Learning from texts or lectures: Loci mnemonics
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21 Hill, R. D., Allen, C., & McWhorter, P. (1991). Stories as a mnemonic aid for older learners.
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44 on Academic Outcomes for Youth with Disabilities: A Systematic Review. Learning
45 Disabilities Research & Practice, 23(1), 1-10. doi: 10.1111/j.1540-
46 5826.2007.00258.x
47 Yang, H. L., Chan, P. T., Chang, P. C., Chiu, H. L., Sheen Hsiao, S. T., Chu, H., & Chou, K.
48 R. (2018). Memory-focused interventions for people with cognitive disorders: A
49 systematic review and meta-analysis of randomized controlled studies. International
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52 Yates, F. (1966). The Art of Memory. London, UK: Pimlico.
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Table 1. Study characteristics
4 Study Setting Participants Recruitment N %f M Age Loci method Control Outcome Final PI Dropout (%)1 Quality
5 (country) procedure (SD) training time Loci Ctrl R A C
6 Bass & Oswald University Students Online and 94 64 19.0 Instructions No Word Same 0 0 - - +
7 (2014) (USA) course credit (1.2) and video instructions recall day
8 Bellezza & Reddy University Students Course credit 72 NS NS Instructions Visualisation Word Same 0 0 - - +
2
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Crovitz (1971)2 University Students Course 70 NS NS Instructions No Word Same 0 0 - - +
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(USA) requirement instructions recall day
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Dalgleish et al. Community Individuals with Newspaper and 42 64 45.6 Instructions Chunking and Memory Two 16 0 + - +
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(2013)3 (UK) depression health centre ads (10.7) and practice rehearsal recall weeks
13De Beni et al. (1997) University Students NS 125 50 NS Three training Rehearsal Word One 0 0 - - +
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1412 (Italy) sessions recall week
15De Beni et al. (1997) University Students NS 34 82 20.0 Three training Rehearsal Word One 0 0 - - +
1624
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(Italy) (NS) sessions recall week
17De Beni et al. (1997) University Students NS 32 NS 20.0 Four training Rehearsal Word Two 0 0 - - +
1833,4 (Italy) (NS) sessions recall weeks
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19Engvig et al. (2010) Community Middle-aged and Newspaper ad 45 51 60.8 Eight week No Source Nine 0 9 - - +
20 (Norway) older adults and interview (9.3) programme instructions memory weeks
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21Hill et al. (1991)3 Community Adults over the Newspaper and 71 61 70.4 Instructions Location Word Three 0 0 - - +
22 (USA) age of 60 TV ads (6.2) memory tips recall days
23Kroneisen & University Students Course credit 48 93 20.3 Instructions Visualisation Word Same 0 0 - - +
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24Makerud (2017) 15 (Germany) (1.9) recall day
25Kroneisen & University Students Course credit 52 81 21.0 Instructions Visualisation Word Same 0 0 - - +
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26Makerud (2017) 26 (Germany) (3.3) recall day
27Legge et al. (2012) University Students Online and 142 62 19.1 Instructions No Word Same 0 0 - - +
7