Test-enhanced learning in health professions education: A systematic review: BEME Guide No. 48

Green, Michael L.; Moeller, Jeremy J.; McKimm, Judy

doi:10.1080/0142159x.2018.1430354

Cited by 81 publications

(72 citation statements)

References 58 publications

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“…Spaced and repeated test enhanced learning promotes better recall and retention again, compared to long single testing or back‐to‐back consecutive testing . Test enhanced learning, as a standalone pedagogy, has demonstrated robust and consistent enhancement of knowledge recall and retention and transfer of medical information …”

Section: Introductionmentioning

confidence: 99%

“…28 Educational content that is spaced and repeated over time (spaced distribution) increases the acquisition and retention of knowledge compared to content delivered at a single time-point (mass or bolus distribution). 29,30 In addition to measuring knowledge, the process of 'testing' alters the learning process itself to facilitate knowledge retention and transfer, [31][32][33][34][35] a phenomenon also referred to as 'test enhanced learning'. 35 Spaced and repeated test enhanced learning promotes better recall and retention again, compared to long single testing or back-to-back consecutive testing.…”

Section: Introductionmentioning

confidence: 99%

“…29,30 In addition to measuring knowledge, the process of 'testing' alters the learning process itself to facilitate knowledge retention and transfer, [31][32][33][34][35] a phenomenon also referred to as 'test enhanced learning'. 35 Spaced and repeated test enhanced learning promotes better recall and retention again, compared to long single testing or back-to-back consecutive testing. [35][36][37] Test enhanced learning, as a standalone pedagogy, has demonstrated robust and consistent enhancement of knowledge recall and retention and transfer of medical information.…”

Section: Introductionmentioning

confidence: 99%

“…35 Spaced and repeated test enhanced learning promotes better recall and retention again, compared to long single testing or back-to-back consecutive testing. [35][36][37] Test enhanced learning, as a standalone pedagogy, has demonstrated robust and consistent enhancement of knowledge recall and retention and transfer of medical information. 35 Spaced education has been widely adopted in a range of undergraduate and postgraduate health courses because it can increase topic-specific knowledge, can change clinical behaviour [38][39][40][41][42][43][44][45][46][47][48] and demonstrates equivalent learning gains compared to online education formats.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review

et al. 2019

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Context Ensuring clinical practice reflects current evidence is challenging given the rapid proliferation of new knowledge. Changing entrenched clinical behaviours and facilitating the adoption of best practice evidence requires a range of strategies, including affordable, scalable and effective continuing professional development (CPD). Yet, identifying the CPD delivery method most likely to effectively change and improve patient outcomes is difficult given the variability in the evidence for different learning approaches. Although there is moderate level evidence for outreach education, audit and feedback, and face‐to‐face or online learning, little is known about the capacity of spaced education to change ineffective clinical practice(s). Spaced education harnesses the power of spacing, repetition and testing learning content to increase topic‐specific knowledge. Although spaced education is widely used in undergraduate and postgraduate medical programmes, its effectiveness as a CPD delivery method that improves patient outcomes is less certain. Aim To determine the effectiveness of the spaced education CPD programmes to change targeted clinical knowledge and practice(s) to improve patient outcomes. Method A systematic review, appraising the spaced education CPD evidence generated from searching six specialist medical and psychosocial databases. Studies published in English peer‐reviewed journals from 1 January, 2000 to 31 August, 2018 were eligible for inclusion. A modified Kirkpatrick four levels of evaluation framework assisted with appraising the effect of spaced education CPD interventions on clinicians and patients. Results Of the 2396 studies identified, 17 met the inclusion criteria, involving 2701 practising clinicians from multiple disciplines and specialties. Five randomised controlled trials generated level II evidence, with the remaining 12 studies generating lower levels of evidence. The majority of studies (n = 14) involved the delivery of online spaced education. All studies were evaluated using the modified Kirkpatrick four levels of evaluation framework with: 10 studies demonstrating significant increases in participants’ knowledge; seven studies reporting significant changes in clinician behaviour; four studies showing significant increases in clinician confidence; and three studies identifying significant and sustained increases in participants’ clinical skills. Only two studies reported positive improvements in patient outcomes. Conclusion Spaced education via an online platform offers a scalable CPD format that can increase clinical knowledge and change practice. However, further adequately powered randomised controlled trials are required to confirm that spaced education CPD can impact positively on patients’ reported outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review

et al. 2019

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“…Some studies show that examinations promote both learning and better retention of information (McLachlan, 2006;Larsen et al, 2008;Wormald et al, 2009;Green et al, 2018). Several authors have shown that being tested is a better way to learn than simply rereading the material (Larsen et al, 2008;Green et al, 2018), as students tend to remember it more effectively, a concept described as the "test effect" (Roediger and Karpicke, 2006a,b;Larsen et al, 2008). In addition, meaningful feedback on the assessment enhances student learning and achievements (Fowell et al, 1999;Larsen et al, 2008;Zhang and Henderson, 2015).…”

Section: Introductionmentioning

confidence: 99%

Summative and Formative Style Anatomy Practical Examinations: Do They Have Impact on Students’ Performance and Drive for Learning?

Mogali

Rotgans

Rosby

et al. 2019

Anatomical Sciences Ed

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Anatomical knowledge is commonly assessed by practical examinations that are often administered in summative format. The format of anatomy practical examination was changed at the Lee Kong Chian School of Medicine in Singapore from summative (graded; must pass) to formative (ungraded; no pass/fail) in academic year (AY) 2017–2018. Both assessment formats were undertaken online, but the formative mode used a team‐based learning activity comprising individual and team assessments. This gave an unique opportunity to investigate: (1) the impact of two different online assessment formats on student performance in practical examination; (2) the impact of new formative practical examination on students’ performance in summative examinations; and (3) students’ opinions of these two practical examination formats. The class of 2021 perceptions was obtained as they experienced both formats. A retrospective cohort study was also conducted to analyze the Year 2 students’ performance in anatomy practical and year‐end summative examinations of cohorts AY 2015–2016, AY 2016–2017 (summative format), and AY 2017–2018 (formative format). There were no significant differences in students’ performance between two practical examination formats. The cohort who experienced the formative format, performed significantly better in summative examinations (mean ± SD: 82.32 ± 10.22%) compared with the cohort who experienced the summative format (73.77 ± 11.09%) (P < 0.001). Students highlighted positive features of the formative practical examination, including team reinforcement of learning, instant feedback, and enhanced learning. These findings indicate that students continue to study for anatomy practical examination without the need for external drivers. The team‐based learning style practical examination enhances students’ performance in summative examinations.

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An Online Program for Primary Care Practitioners to Enhance Confidence in Ability to Care for Patients With or at Risk of Painful Knee Osteoarthritis

Mandl,

Lin,

Gottesman

et al. 2023

ACR Open Rheumatology

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ObjectivePrimary care practitioners (PCPs) care for the majority of patients with knee osteoarthritis (KOA). Despite the existing evidence‐based guidelines, PCPs often feel unequipped to evaluate and effectively treat patients with KOA. To address this need, we designed and implemented a free internet‐based program focusing on the diagnosis and treatment of KOA. We assessed whether the program led to improvements in participants’ confidence in their knowledge and skills related to effectively recognizing and caring for patients with or at risk of KOA.MethodsWe used Caffarella's integrative model to develop a program aligned with the American College of Rheumatology 2019 Guideline for the treatment of KOA. The program incorporated 18 case‐based questions to provide retrieval practice and mastery experiences. We assessed changes in participants’ confidence in their KOA knowledge and skills after program completion.ResultsOf the first 353 learners completing the program, 53.8% were women, 41.9% had a clinical focus in primary care, and 69.1% were nonphysicians. Overall confidence in KOA knowledge and skills improved after program completion (P < 0.001; effect size = 1.28, 95% confidence interval 1.12–1.45), with largest improvements among participants with lower pre‐program confidence. A total of 95.8% of participants indicated they would recommend the program to others.ConclusionA free online program focusing on the effective care for patients with KOA attracted a wide range of learners, even though it targeted PCPs. Participants overwhelmingly endorsed it as highly relevant and would recommend it to others. Whether improvements in confidence translate into better patient outcomes is an important area for future research.

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Test-enhanced learning in health professions education: A systematic review: BEME Guide No. 48

Cited by 81 publications

References 58 publications

Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review

Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review

Summative and Formative Style Anatomy Practical Examinations: Do They Have Impact on Students’ Performance and Drive for Learning?

An Online Program for Primary Care Practitioners to Enhance Confidence in Ability to Care for Patients With or at Risk of Painful Knee Osteoarthritis

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