Instructional Design Unlocks the Effects of Prior Knowledge Activation in Surgical Education

These findings challenge the widespread assumption that PKA is universally beneficial as a standalone intervention. Instead, PKA effectiveness seems to depend on instructional context, specifically the presence of concurrent verbal instruction. This may involve explicitly referencing activated knowledge during instruction, using narration to scaffold connections that prompt learners to integrate prior understanding with new material. Designing for such alignment seems key to realize the benefits of PKA in multimedia learning environments.