Combine Retrieval Practice and Spaced Repetition Into a Powerful Teaching-Learning Tool
Healthcare curricula is rigorous and demanding on time, resources, and learning stamina. To manage these challenges and perform well on licensure and certification exams, learners must be able to learn efficiently, retain the information over a long period, and recall it easily when needed. Educators can support this by embracing two proven learning science techniques that strengthen concept mastery and improve learners’ exam readiness1—retrieval practice and spaced repetition—and leveraging quizzing as a teaching and active learning tool.
Retrieval Practice: Recall information With Ease
Retrieval practice involves testing the learner on previously learned material—pulling information out of the learner’s brain instead of trying to cram more in—through methods such as flashcards and low-stakes quizzes. This encourages learners to actively engage with the material instead of passively absorbing information, which aids in the retrieval and consolidation of the material into long-term memory. Research has shown that this approach is more effective for learning and makes the information easier to recall compared to repeated study or concept mapping,2 while classroom application has demonstrated its efficacy across age groups and subject domains.3 There is also evidence that retrieval practice promotes the development of higher-order thinking and metacognitive skills and that learners who use this method perform better on complex tasks.4
Spaced Repetition: Improve Long-Term Knowledge Retention
Spaced repetition is a learning method that involves increasing the time intervals between each material review. At the beginning of the learning process, these intervals are spaced closely together (for example, once per day). As the learner becomes more familiar with the material, the interval periods become longer (for example, from once a day to once every three days). This creates a “spacing effect” that leads to better memory retention compared to massed repetition (reviewing the information many times within a short time frame). Spaced repetition is so effective because it encourages the brain to work harder to retrieve key information over and over again, creating a deeper level of processing in the learner’s long-term memory. This technique also helps improve various forms of learning including memory, problem-solving, and adapting to new situations or information.5 One study tested the effect of spaced repetition on microsurgical skills among medical students and found that they performed significantly better even one month after training compared to students who relied on massed learning (repeated practice over many hours in one sitting).6
Quizzing: Maximize Learning Outcomes Through “Spacing-Retrieval” Effect
Retrieval practice and spaced repetition can be easily integrated into the classroom to augment didactics and enhance learning, performance, and outcomes. But an even better way to leverage the impact of both is to combine them into one learning tool—quizzing. This creates the dual effect of “spacing-retrieval” on learning that amplifies memory encoding, long-term knowledge storage, and easy recall of information compared to using either strategy alone.
One key advantage of quizzing is its versatility and flexibility—the format, content, and difficulty level can be adapted or customized to suit learners’ needs, strengths and weaknesses, and goals. Quizzes can be utilized as a classroom activity, assigned to learners to complete individually, coupled with reading assignments, and as a formative or summative assessment tool. This allows quizzing to deliver two main benefits: assess learners’ current knowledge levels and build on it to strengthen comprehension and mastery.
In a study involving 151 medical students, quizzing significantly improved post-test scores—from just 3% scoring in the range of 61%-80% pre-test to 93% scoring above 81% post-test.7 Similarly, research has shown its positive impact on dental students—those who took a practice quiz scored 8.8% higher on a summative exam compared to their counterparts who skipped the quiz.8 Learners have also reported that they find quiz-based learning to be more engaging and interactive, thus elevating their eagerness to learn and encouraging better participation in the classroom or learning process.7
Quizzing as a Teaching-Learning Tool in Healthcare Education
Here are 5 reasons educators should embrace quizzing as a teaching-learning resource:
| Reasons | Descriptions |
|---|---|
| Improve Retention | Quizzing can promote information recall from long-term memory and encourage improved knowledge retention.1,2 This helps overcome the loss of learning that occurs when information is not retained or utilized, with experts suggesting that this can happen to up to 90% of new information within 18-24 hours.9 |
| Get Immediate Feedback | Quizzing provides educators with immediate feedback on learners’ understanding of the material, helping them identify individual strengths and weaknesses while highlighting knowledge gaps and at-risk learners.10 Instant feedback can be appealing and desirable to Generation Z and X learners, and it can also provide a sense of accomplishment when they do well. |
| Increase Engagement | Active learning methods such as retrieval practice can be a fun and engaging activity for learners, especially when it involves competitive or collaborative aspects in the classroom.11 |
| Accurately Assess Performance | Leveraging formative and summative assessments throughout the curriculum and utilizing the aggregate data surfaces insights that inform educators on learners’ and cohorts’ understanding of the material, allowing them to adjust their lesson plans and provide support where needed. |
| Strengthen Metacognition | Regular retrieval practice tasks in a low-stakes environment support higher-order thinking and improve metacognition.4 As learners’ metacognitive abilities increase, they can focus on what they need to learn, thus enhancing their understanding, knowledge retention, and learning outcomes. |
Integrating quizzing into the classroom and curriculum benefits both educators and learners, ultimately leading to optimal learning, exam, and program outcomes. Item writing, creating quizzes, and grading can eat up academic hours; however, programs can leverage digital learning platforms that provide access to board-style questions and quizzing tools, powered by a robust data analytics engine to drive desired academic results and reduce the burden on faculty.
Find out how an e-learning solution built on cognitive science and powered by data analytics lets you easily integrate quizzing into your curriculum to steer success for your program.
References
1 Roediger HL III, Karpicke JD. The power of testing memory: Basic research and implications for educational practice. Perspect Psychol Sci. 2006;1(3):181-210. doi:10.1111/j.1745-6916.2006.00012.x
2 Karpicke JD, Blunt JR. Retrieval practice produces more learning than elaborative studying with concept mapping. Science. 2011;331(6018):772-775. doi:10.1126/science.1199327
3 McDermott KB. Practicing retrieval facilitates learning. Annu Rev Psychol. 2021;72(1):609-633. doi:10.1146/annurev-psych-010419-051019
4 Agarwal PK, Bain PM. Powerful Teaching: Unleash the Science of Learning. Jossey-Bass; 2019. doi:10.1002/9781119549031
5 Kang SHK. Spaced repetition promotes efficient and effective learning: Policy implications for instruction. Policy Insights Behav Brain Sci. 2016;3(1):12-19. doi:10.1177/2372732215624708
6 Moulton CAE, Dubrowski A, MacRae H, Graham B, Grober E, Reznick R. Teaching surgical skills: What kind of practice makes perfect?: A randomized, controlled trial. Ann Surg. 2006;244(3):400-409. doi:10.1097/01.sla.0000234808.85789.6a
7 Dengri C, Gill A, Chopra J, et al. A review of the quiz, as a new dimension in medical education. Cureus. 2021;13(10). doi:10.7759/cureus.18854
8 Olson BL, McDonald JL. Influence of online formative assessment upon student learning in biomedical science courses. J Dent Educ. 2004;68(6). Accessed August 15, 2023. https://pubmed.ncbi.nlm.nih.gov/15217084/
9 Sousa DA. How the Brain Learns. Corwin; 2022.
10 Kornell N, Bjork RA. The promise and perils of self-regulated study. Psychological Science. 2007;18(3):219-224.
11 Pashler H, McDaniel M, Rohrer D, Bjork R. Learning styles: Concepts and evidence. Psychol Sci Public Interest. 2008;9(3):105-119. doi:10.1111/j.1539-6053.2009.01038.x
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