Online Spaced Education Generates Transfer and Improves Long-Term Retention of Diagnostic Skills: A Randomized Controlled Trial

Kerfoot, B. Price; Fu, Yang; Baker, Harley; Connelly, Donna; Ritchey, Michael L.; Genega, Elizabeth M.

doi:10.1016/j.jamcollsurg.2010.04.023

Cited by 131 publications

(134 citation statements)

References 18 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…34 Multiple studies have demonstrated improved learning efficiency and knowledge retention using spaced education in surgical residencies and undergraduate medical education when material was delivered over months to years. 22,23,[25][26][27]35,36 Our study showed the utility of spaced education over a month-long rotation. Considerable attrition may have played a role in our inability to detect a significant difference in test performance at the 3-month follow up.…”

Section: Discussionmentioning

confidence: 57%

See 1 more Smart Citation

A Randomized Educational Interventional Trial of Spaced Education During a Pediatric Rotation

House

Monuteaux

Nagler

2017

AEM Education and Training

View full text Add to dashboard Cite

Objective: Spacing of educational material over time has been shown to improve learning efficiency and long-term knowledge retention. We evaluated the impact of adding a spaced education curriculum to a month-long pediatric rotation.Methods: This was a randomized controlled educational intervention trial of residents on a rotation in a pediatric emergency department. Participants were randomized to the standard curriculum or the standard curriculum with integrated spaced education. The intervention used an automated platform to electronically deliver questions to user e-mail or mobile devices and provided instant feedback. Our primary outcome was proportion of correctly answered questions following the rotation. Our secondary outcomes included test performance at 3 months, change in clinical confidence, and satisfaction with the spaced learning. Learner opinion of the platform was assessed by postrotation survey.Results: Of 194 eligible trainees, 122 were enrolled and randomized. A total of 107 of the enrolled residents (88%) completed the immediate postrotation assessment, 48 of whom received spaced education. Sixty residents completed the 3-month follow-up. There were no differences between the control and intervention groups in baseline knowledge. The intervention group performed better than the control group on the postrotation assessment (mean difference = 5.4%, 95% confidence interval = 0.1-10.7) when controlled for didactic attendance and clinical exposure. Change in confidence did not differ between groups. Eighty-seven percent of spaced education learners would participate in a similar model in the future. Conclusion:Spaced education during a pediatric emergency medicine rotation is an effective adjunct to a standard curriculum. Participants showed improvement on postrotation knowledge performance and enjoyed this educational approach.T he standard residency education prescribed by the Accreditation Council for Graduate Medical Education (ACGME) incorporates bedside teaching and didactic curricula.1-3 Studies capturing resident experience have shown gaps in clinical exposure.4-10 Many training programs incorporate simulation and online modules to standardize exposure. [11][12][13][14][15][16][17][18][19][20] Web-based modules and lectures can supplement clinical experience, most effectively when used in conjunction with face-to-face instruction. 21 An alternative strategy is the use of spaced education, which is the interval presentation of educational material over a prescribed period of time. Studies of surgical residents and medical students have demonstrated that spaced education initiatives spanning months to years improve learning efficiency and longterm knowledge retention. [22][23][24][25][26][27][28] Web-based spaced education may be an effective approach for residents on an emergency medicine rotation with asynchronous clinical schedules.

show abstract

Section: Discussionmentioning

confidence: 57%

“…Studies of surgical residents and medical students have demonstrated that spaced education initiatives spanning months to years improve learning efficiency and longterm knowledge retention. [22][23][24][25][26][27][28] Web-based spaced education may be an effective approach for residents on an emergency medicine rotation with asynchronous clinical schedules. …”

mentioning

confidence: 99%

A Randomized Educational Interventional Trial of Spaced Education During a Pediatric Rotation

House

Monuteaux

Nagler

2017

AEM Education and Training

View full text Add to dashboard Cite

show abstract

“…[12][13][14][15][16][17] The SE approach is based on the spacing effect-the principle that exposure to concepts distributed and repeated over time improves learning. 18 Online SE with questions uses both the spacing effect and the testing effect (the principle that testing improves knowledge retention while evaluating a learner's performance).…”

Section: Introductionmentioning

confidence: 99%

“…Kerfoot and colleagues measured the efficacy of SE with improved scores on repeated administration of the same questions. 13,14,16,17 We sought to assess the generalizability of SE across different domains by creating an innovative SE program with clinical images of 4 common skin conditions. Our hypothesis was that SE would be an acceptable learning method and would significantly improve pediatrics residents' knowledge of pediatric dermatology when knowledge gain and application were assessed with an outcome measure different from the intervention (unique and isomorphic questions).…”

Section: Introductionmentioning

confidence: 99%

Randomized Controlled Trial of Spaced Education for Pediatric Residency Education

Mathes¹,

Frieden²,

Cho³

et al. 2014

Journal of Graduate Medical Education

View full text Add to dashboard Cite

IntroductionAs work hour limits change and time for formal education in residency decreases, primary care residencies struggle to fit essential subspecialty instruction into limited didactic time. Despite the high frequency of skin-related complaints in pediatrics, dermatology remains a significant knowledge gap for pediatricians. [1][2][3][4][5][6][7][8][9][10][11] Online learning tools can provide educational opportunities unrestricted by time or location.Online spaced education (SE) has been shown to be an effective and acceptable method for addressing knowledge and practice gaps in medical education.12-17 The SE approach is based on the spacing effect-the principle that exposure to concepts distributed and repeated over time improves learning.18 Online SE with questions uses both the spacing effect and the testing effect (the principle that testing improves knowledge retention while evaluating a learner's performance). In urology studies, Kerfoot et al 16 demonstrated knowledge gains that persist for up to 2 years. The method's promising results as an instruction tool have led to the increasing use of SE in medical education. Kerfoot and colleagues measured the efficacy of SE with improved scores on repeated administration of the same questions. 13,14,16,17 We sought to assess the generalizability of SE across different domains by creating an innovative SE program with clinical images of 4 common skin conditions. Our hypothesis was that SE would be an acceptable learning method and would significantly improve pediatrics residents' knowledge of pediatric dermatology when knowledge gain and application were assessed with an outcome measure different from the intervention (unique and isomorphic questions). Methods DesignParticipating residents were randomized into 2 groups (groups A and B) and exposed to 2 different courses. Group The authors would like to thank B. Price Kerfoot for his guidance in the planning stages of the study and spaceded.com for providing a secure site for the study.Corresponding author: Erin F. Mathes, MD, 1701 Divisadero Street, Box 0316, San Francisco, CA 94143-0316, 415.353.7880, mathese@derm.ucsf.edu Received February 18, 2013 revisions received September 18, 2013, and November 12, 2013; accepted December 2, 2013. DOI: http://dx.doi.org/10.4300/JGME-D-13-00056.1 AbstractBackground Spaced education (SE) has shown promise as an instructional tool that uses repeated exposure to the same questions, but information on its utility in graduate medical education is limited, particularly in assessing knowledge gain with outcome measures that are different from repeat exposure to the intervention questions.

show abstract

“…As the task is repeated over an extended period of time, long-term structural modifications occur in the brain 18,19 . Furthermore, simulation allows for regular interval training to accelerate acquisition of correctly performed motor skills, thereby increasing the learner's ability to retain those skills and building learner confidence in a low-stress environment 20,21 .…”

Section: Discussionmentioning

confidence: 99%

A Cost-Effective Junior Resident Training and Assessment Simulator for Orthopaedic Surgical Skills via Fundamentals of Orthopaedic Surgery

Lopez

Wright

Martín

et al. 2015

The Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

show abstract

Online Spaced Education Generates Transfer and Improves Long-Term Retention of Diagnostic Skills: A Randomized Controlled Trial

Cited by 131 publications

References 18 publications

A Randomized Educational Interventional Trial of Spaced Education During a Pediatric Rotation

A Randomized Educational Interventional Trial of Spaced Education During a Pediatric Rotation

Randomized Controlled Trial of Spaced Education for Pediatric Residency Education

A Cost-Effective Junior Resident Training and Assessment Simulator for Orthopaedic Surgical Skills via Fundamentals of Orthopaedic Surgery

Contact Info

Product

Resources

About