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Academic Medicine:
doi: 10.1097/ACM.0000000000000117
Letters to the Editor

In Reply to Deng and Gluckstein

Bow, Hansen C. PhD; Dattilo, Jonathan R.; Jonas, Andrea M.; Lehmann, Christoph U. MD

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Fourth-year medical student, Johns Hopkins University, Baltimore, Maryland.

Fourth-year medical student, Johns Hopkins University, Baltimore, Maryland.

Fourth-year medical student, Johns Hopkins University, Baltimore, Maryland.

Professor of pediatrics and biomedical informatics, Vanderbilt University, Nashville, Tennessee; christoph.u.lehmann@vanderbilt.edu.

Disclosures: Dr. Lehmann is editor-in-chief of Applied Clinical Informatics and sits on the boards of directors of the American Medical Informatics Association and the International Medical Informatics Association.

We appreciate Deng and Gluckstein’s informative summary of spaced repetition systems and their critical analysis of our article. We agree that spaced repetition systems hold tremendous promise for facilitating cumulative recall in medical education. Osmosis, a popular medical school board review application, was developed after our project by students at the Johns Hopkins University School of Medicine (the authors here are not involved) and relies heavily on spaced repetition to facilitate long-term recall.1

The purpose of our original report, however, was to describe the process of creation and dissemination of study materials with specific focus on the collaborative “crowd-sourcing” process. To this effect, perhaps the quoted statement “redefined how students study preclinical materials” should have been more appropriately clarified with “redefined how students create preclinical study materials.” Medical students have traditionally been seen as a highly competitive group. We feel the significance of our study rests in our description of the simple, user-friendly models that facilitated cooperation among classmates. We created resources that allowed for collaboration, sharing of resources, and joint efforts to optimize learning.

Deng and Gluckstein’s assertion that we dismissed third-party software programs highlights a failure on our part to adequately describe how the software was designed and advertised. At the header of each Google Doc was a link to both our software download page as well as links to both StudyBlue and Anki in an effort to promote these alternative software systems. However, despite the availability of third-party software we opted to create our own software for (1) the ability to conveniently display PowerPoint slides in the form of flashcards, which we considered crucial for the adoption of our system because of user familiarity with PowerPoint and Excel; and (2) the observation that available software, while elegant, inhibited collaboration. For example, Anki allows creation and annotation of pictures as flashcards, but all annotations can only be saved on the Web site and are not easily shared with classmates. Our software was rudimentary by design, with two simple purposes: to remain user friendly and to display both Excel and PowerPoint files.

We do acknowledge the many benefits of more complex commercial systems, including those utilizing spaced repetition. At the time of our prestudy assessment of available flashcard software, no tool existed that was capable of displaying the content we deemed necessary for successful student collaboration. It is our hope that future software developments will close the gap and produce tools that allow improved collaborative creation of content combined with both user-friendly displays and more complex repetition algorithms.

Hansen C. Bow, PhD

Fourth-year medical student, Johns Hopkins

University, Baltimore, Maryland.

Jonathan R. Dattilo

Fourth-year medical student, Johns Hopkins

University, Baltimore, Maryland.

Andrea M. Jonas

Fourth-year medical student, Johns Hopkins

University, Baltimore, Maryland.

Christoph U. Lehmann, MD

Professor of pediatrics and biomedical informatics,

Vanderbilt University, Nashville, Tennessee;

christoph.u.lehmann@vanderbilt.edu.

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Reference

1. . Knowledge Diffusion. Osmosis Med [app]. https://itunes.apple.com/us/app/osmosis-med/id646540641. Accessed October 28, 2013

© 2014 by the Association of American Medical Colleges

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