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interleaving implementation: the ‘near-neighbour sets’ method

how to interleave properly: build confusable sets, mix them on purpose, and force discrimination under time pressure.

The Bottom Line

  • Interleaving only works if the items are meaningfully confusable.
  • Build ‘near-neighbour’ sets (3–6 conditions) and mix questions across them.
  • The goal is discrimination: the one feature that flips the answer.

Most ‘interleaving’ is fake

If you mix unrelated topics (e.g., AF, psoriasis, hyponatraemia) you’re creating noise—not the discrimination pressure interleaving is meant to generate.
Interleaving is powerful, but underused because it feels harder and makes you look ‘worse’ short-term. For exam performance, that discomfort is often the point: you’re training selection under uncertainty.
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Step 1: Build a near-neighbour set

Pick 3–6 conditions that commonly get confused (e.g., cellulitis vs DVT vs gout; ulcerative colitis vs Crohn’s; PE vs pneumonia vs HF).
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Step 2: Create a discriminator list

For each pair, write the single best discriminator (not a textbook description).
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Step 3: Mix questions deliberately

Do 12–20 questions drawn from the whole set. Don’t separate by topic; force the decision.
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Step 4: Review by discriminator, not explanation

After the block, update your discriminator list with what actually fooled you.
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Step 5: Retest the set

Re-run a smaller mixed block 72 hours later. This is where the durable learning appears.

High-quality interleaving

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Practice

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SourceWhy learners underuse interleaving (and how to counter it)
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