Pictures and words together

The idea in one sentence: a picture plus spoken words gives people two ways into memory, so show the picture and say the words, and don’t make people read and look at the same time.

You’ve seen this already

Think about a sat nav. It shows a simple map and a voice says “in 200 yards, turn left”. Your eyes take in the picture and your ears take in the words, and the two fit together.

Now imagine the sat nav showed the map with a paragraph of written directions underneath, and read them out too. You’d be flicking your eyes between the words and the map, trying to keep up. Same information, more work.

Most of us also find it easier to remember a face than a name, and “a red fire engine” than “a sense of urgency”. Things you can picture tend to stick.

Why it matters for your teaching

Say you’re showing staff a new hoist sling at a huddle. You could hand round a sheet of text and read it out. Or you could hold up the sling, point to the loops, and tell people which ones go where. The second way uses a picture (the real thing) and your voice together. Nobody has to read and look at once.

Slides work the same way. A slide full of sentences pulls people’s eyes away from any picture on it, and away from you. A clear picture, a few key words and your voice work together. The detail goes in your notes or a handout.

None of this starts with the picture, though. Start with what people need to do differently, then choose the one picture that helps them do it. A busy infographic is just more clutter (see cognitive load).

Try this

• Show it and say it. Pair one clear picture, diagram or real object with your spoken explanation. Let your voice carry the words.
• Don’t read out a slide full of text. If there’s a picture on the slide, the written words compete with it for people’s eyes. A few short labels next to the right part of a diagram are fine, and can help.
• Find something to picture. Concrete things are easier to remember. For an abstract idea, like a new escalation policy, use a real example, a timeline or a simple flow chart.
• Ask people to sketch it after they’ve tried to recall it. Drawing a quick map of how the ideas connect can help, probably because people have to work out the links. Asking them to remember first, then draw, is likely to work better still.

How sure are we?

Fairly sure, within limits. That concrete words and pictures are easier to remember than abstract words is a well-repeated finding in memory research. The advice about slides comes from many short lab experiments, mostly with university students learning from short, narrated lessons, tested soon after. It has rarely been tested in healthcare workplaces.

The harm from on-screen text shows up mainly when there’s also a picture. When a slide has text only, one large review found that reading it out does no harm, and may help people new to the topic. The bigger risk then is that people read ahead of you.

The biggest myth to avoid: this is not “learning styles”. The idea that some people are “visual learners” and should be taught with pictures has no good evidence behind it. A picture plus your voice tends to help most people, especially those new to a topic.

Where it comes from

Allan Paivio, a Canadian psychologist, set out dual coding theory in 1971. He argued that we store words and images in two separate but linked systems, so something stored both ways has two routes back. Richard Mayer, an American educational psychologist, built on this in his 2001 book Multimedia Learning. He tested which mixes of words and pictures help people learn, and turned the results into design rules.