Does spaced education improve clinical knowledge among Family Medicine residents? A cluster randomized controlled trial

Abstract

Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency. We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine certification examination. Method: We conducted a cluster randomized controlled trial to empirically and pragmatically test spaced education using two versions of the Family Medicine Study Guide mobile app. 12 residency training programs in Canada agreed to participate. At six intervention sites, we consented 335 of the 654 (51%) eligible residents. Residents in the intervention group were sent alerts through the app to encourage the answering of questions linked to clinical cases. At six control sites, 299 of 586 (51%) residents consented. Residents in the control group received the same app but with no alerts. Incidence rates of case completion between trial arms were compared using repeated measures analysis. We linked residents in both trial arms to their knowledge scores on the certification examination of the College of Family Physicians of Canada. Results: Over 67 weeks, there was no statistically significant difference in the completion of clinical cases by participants. The difference in mean exam scores and the associated confidence interval did not exceed the pre-defined limit of 4 percentage points. Conclusion: Further research is recommended before deploying spaced educational interventions in the Family Medicine residency to improve knowledge.

Effectiveness of spaced repetition for clinical problem solving amongst undergraduate medical students studying paediatrics in Pakistan

“…Similarly, in clinical fields requiring more application of knowledge than just factual recall, the use of flashcards has also been shown to improve performance scores and retention, such as in the fields of obstetrics and gynaecology, radiology, psychiatry, urology and otolaryngology and internal medicine [14][15][16][17][18][19]. With respect to the field of pediatrics in particular, most studies performed to show the effectiveness of spaced repetition have been conducted mainly at the postgraduate and professional levels.…”