Application of Frequent, Spaced Multiple‐choice Questions as an Educational Tool in the Pediatric Emergency Department

Abstract

Objectives:The objective was to assess the feasibility of using spaced multiple-choice questions (MCQs) to teach residents during their pediatric emergency department (PED) rotation and determine whether this teaching improves knowledge retention about pediatric rashes.Methods: Residents rotating in the PED from four sites were randomized to four groups: pretest and intervention, pretest and no intervention, no pretest and intervention, and no pretest and no intervention. Residents in intervention groups were automatically e-mailed quizlets with two MCQs every other day over 4 weeks (20 questions total) via an automated e-mail service with answers e-mailed 2 days later. Retention of knowledge was assessed 70 days after enrollment with a posttest of 20 unique, content-matched questions.Results: Between August 2015 and November 2016, a total 234 residents were enrolled. The completion rate of individual quizlets ranged from 93% on the first and 76% on the 10th quizlet. Sixty-six residents (55%) completed all 10 quizlets. One-hundred seventy-three residents (74%) completed the posttest. There was no difference in posttest scores between residents who received a pretest (61.0% AE 14.5%) and those who did not (64.6% AE 14.0%; mean difference = -3.7, 95% confidence interval [CI] = -8.0 to 0. 6) nor between residents who received the intervention (64.5% AE 13.3%) and those who did not receive the intervention (61.2% AE 15.2%; mean difference = 3.2, 95% CI = -1.1 to 7.5). For those who received a pretest, scores improved from the pretest to the posttest (46.4% vs. 60.1%, respectively; 95% CI = 9.7 to 19.5). Conclusion:Providing spaced MCQs every other day to residents rotating through the PED is a feasible teaching tool with a high participation rate. There was no difference in posttest scores regardless of pretest or intervention. Repeated exposure to the same MCQs and an increase in the number of questions sent to residents may increase the impact of this educational strategy.From the

Engagement and learning in an electronic spaced repetition curriculum companion for a paediatrics academic half-day curriculum

“…Finally, it is also possible that two reinforcements are not enough to establish durable retention, as more questions are more beneficial to establishing test-enhanced learning [ 16 ]. A recent randomized controlled trial using electronically delivered MCQs to enhance learning in a paediatric emergency medicine rotation also found no difference between residents who had or had not received test-enhanced learning, in spite of high participation [ 17 ]. Though spacing of test questions was present in that trial, there was no spaced repetition, which may be another critical component when assessing distant recall.…”

Experiences from Two Ways of Integrating Pre- and Post-course Multiple-choice Assessment Questions in Educational Events for Surgeons

“…Test-enhanced learning is being increasingly incorporated into continuing medical education (CME) and continuing professional development (CPD) courses due to its demonstrated impact on knowledge retention and its value in assessing the efficacy of the course in imparting prescribed learning outcomes [3,6,8,9]. The introduction of pre-course assessment identifies gaps in knowledge and enhances learning at the course [6,10].…”