Skip Navigation LinksHome > February 2014 - Volume 89 - Issue 2 > Tools to Improve Long-Term Retention of Preclinical Knowledg...
Academic Medicine:
doi: 10.1097/ACM.0000000000000112
Letters to the Editor

Tools to Improve Long-Term Retention of Preclinical Knowledge

Deng, Francis; Gluckstein, Jeffrey

Free Access
Article Outline
Collapse Box

Author Information

Second-year medical student, Washington University School of Medicine, St. Louis, Missouri; francisdeng@wustl.edu.

Second-year medical student, Washington University School of Medicine, St. Louis, Missouri.

Disclosures: None reported.

Back to Top | Article Outline

To the Editor:

We commend Bow et al1 for developing tools to collaboratively generate flashcards. The authors claimed that their Hopkins Med Flashcards “redefined how students study preclinical material.” However, many students used the flashcards infrequently or read them like notes, an inefficient approach that epitomizes traditional studying.2 We contend that the authors missed an opportunity to encourage more effective strategies by dismissing programs such as Anki,3 a free, open-source, spaced repetition flashcard application that many students currently use.

Spaced repetition systems ask questions over increasing time intervals adapted to user-rated difficulty, shifting the focus of preclinical studying from cramming for an exam to long-term retention. Cumulative reviews continue after courses end. Controlled implementations of spaced repetition in undergraduate medical education have improved knowledge retention and been well accepted.4 In our own preclinical studies, we have embraced daily use of spaced repetition software.

Without scheduling spaced reviews, the authors’ system is unlikely to improve retention over traditional study methods. One randomized trial using medical students demonstrated that massed retesting with electronic flashcards (akin to the Hopkins Med Flashcards) was superior to massed restudying (akin to rereading notes) for short-term recall but not long-term retention.5 In another study, allowing students to stop reviewing items they think they know, as the self-regulated Hopkins Med Flashcards system does, had consistently negative effects on recall.6

We remain hopeful, however, that classwide collaboration will generate effective educational materials when enmeshed with pedagogically refined systems like spaced repetition. We further encourage education researchers to assess the tools used by students, as ambitious learners like Bow et al will go to great lengths to study effectively.

Francis Deng

Second-year medical student, Washington University

School of Medicine, St. Louis, Missouri; francisdeng@wustl.edu.

Jeffrey Gluckstein

Second-year medical student, Washington University

School of Medicine, St. Louis, Missouri.

Back to Top | Article Outline

References

1. Bow HC, Dattilo JR, Jonas AM, Lehmann CU. A crowdsourcing model for creating preclinical medical education study tools. Acad Med. 2013;88:766–770

2. Karpicke JD, Roediger HL 3rd. The critical importance of retrieval for learning. Science. 2008;319:966–968

3. Elmes D. Anki. http://ankisrs.net. Accessed July 27, 2013

4. Kerfoot BP, Baker H, Pangaro L, et al. An online spaced-education game to teach and assess medical students: a multi-institutional prospective trial. Acad Med. 2012;87:1443–1449

5. Schmidmaier R, Ebersbach R, Schiller M, Hege I, Holzer M, Fischer MR. Using electronic flashcards to promote learning in medical students: retesting versus restudying. Med Educ. 2011;45:1101–1110

6. Kornell N, Bjork RA. Optimising self-regulated study: the benefits—and costs—of dropping flashcards. Memory. 2008;16:125–136

© 2014 by the Association of American Medical Colleges

Login

Article Tools

Share