It was a pleasure to see a letter to the editor in Anesthesiology that mentioned the learning advantage of pictures compared to words. This advantage is known as the picture superiority effect. I was skeptical of the stated learning advantage of the picture superiority effect when the authors describe that the picture superiority effect results in a 650% increase in retained information after 3 days. To pursue the evidence behind this claim I reviewed the citation provided by the authors. Unfortunately, the citation was a book that provided only an infographic. This infographic referenced another book, but that too did not provide a citation to the original work. Subsequently, I sought peer-reviewed studies with measures of the size of the picture superiority effect. Randomized controlled studies support the picture superiority effect but with a substantially lower effect size. For example, the benefit of pictures over just...

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