Using electronic flashcards to promote learning in medical students: retesting versus restudying

Schmidmaier, Ralf; Ebersbach, René; Schiller, Miriam; Hege, Inga; Holzer, Matthias; Fischer, Martin R.

doi:10.1111/j.1365-2923.2011.04043.x

Cited by 85 publications

(65 citation statements)

References 41 publications

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“…Also, repeated testing has been regarded as a measure that could prevent knowledge decay [28], which may lead one to assume that an even higher loss would be found if students were tested only once, one year after the teaching period. As far as the clinical skills assessment is concerned, the pediatric cardiology model adopted seems to us particularly adequate for an OSCE, since the physical findings of the most frequent congenital heart defects varies little from patient to patient [29] and therefore different patients could be used, in order to minimize such memorization effect.…”

Section: Discussionmentioning

confidence: 99%

Retention of Knowledge and Clinical Skills by Medical Students: A Pro-spective, Longitudinal, One-Year Study Using Basic Pediatric Cardiology as a Model

Amaral¹,

Troncon

2013

TOMEDEDUJ

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Abstract:Background: Retention of early-taught knowledge and fundamental clinical skills, albeit essential in medical education, has not been extensively investigated. This study is aimed at assessing prospectively the retention of knowledge and skills related to communication with patients and the physical examination by fourth year medical students after an introductory course in basic pediatric cardiology.Methods: Three cohorts of fourth year medical students aged 21-26 years volunteered for the study. All students (N = 130) were assessed immediately after the teaching period and after six months (N = 42) and after one year (N = 21) later. Assessments included a 40 multiple-choice question (MCQ) test and an 8-station objective structured clinical examination (OSCE) focused on communication with patients, physical examination and interpretation of diagnostic tests (chest radiographs and electrocardiograms). Cases were portrayed by either real, rehearsed patients or standardized patients. Student performance was assessed by trained staff members using structured checklists.Results: For all aspects of knowledge assessed, scores obtained in the second and the third assessment were significantly lower than those verified in the first assessment. There were no significant differences between the three assessments regarding overall clinical performance and data for communication with patients and physical examination. Concerning diagnostic tests interpretation, scores obtained in the second and third assessment were significantly lower than those verified in the first assessment. Paired analysis of the results obtained for the 21 students who took the three assessments showed similar results, except for a trend for improvement in clinical skills.Conclusions: Medical student retention of clinical sciences knowledge follows a pattern similar to that found in other scientific domains, characterized by progressive decay after initial acquisition. In contrast, fundamental clinical skills, such as communication with patients and physical examination are substantially retained, which could be ascribed to continuous practice. These findings should be taken into account for devising instructional strategies for enhancing student knowledge and clinical skills maintenance.

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Section: Discussionmentioning

confidence: 99%

Retention of Knowledge and Clinical Skills by Medical Students: A Pro-spective, Longitudinal, One-Year Study Using Basic Pediatric Cardiology as a Model

Amaral¹,

Troncon

2013

TOMEDEDUJ

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“…This content matches with the pathomechanisms of the used cases. The content of the flashcards was previously published in another study (appendix S1 (online) of Schmidmaier et al [17]). Within a 3 h electronic learning module it was ensured by testing that all participants could retrieve the contents of each flash card at least once.…”

Section: Methodsmentioning

confidence: 99%

Knowledge is not enough to solve the problems – The role of diagnostic knowledge in clinical reasoning activities

et al. 2016

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BackgroundClinical reasoning is a key competence in medicine. There is a lack of knowledge, how non-experts like medical students solve clinical problems. It is known that they have difficulties applying conceptual knowledge to clinical cases, that they lack metacognitive awareness and that higher level cognitive actions correlate with diagnostic accuracy. However, the role of conceptual, strategic, conditional, and metacognitive knowledge for clinical reasoning is unknown.MethodsMedical students (n = 21) were exposed to three different clinical cases and instructed to use the think-aloud method. The recorded sessions were transcribed and coded with regards to the four different categories of diagnostic knowledge (see above). The transcripts were coded using the frequencies and time-coding of the categories of knowledge. The relationship between the coded data and accuracy of diagnosis was investigated with inferential statistical methods.ResultsThe use of metacognitive knowledge is correlated with application of conceptual, but not with conditional and strategic knowledge. Furthermore, conceptual and strategic knowledge application is associated with longer time on task. However, in contrast to cognitive action levels the use of different categories of diagnostic knowledge was not associated with better diagnostic accuracy.ConclusionsThe longer case work and the more intense application of conceptual knowledge in individuals with high metacognitive activity may hint towards reduced premature closure as one of the major cognitive causes of errors in medicine. Additionally, for correct case solution the cognitive actions seem to be more important than the diagnostic knowledge categories.

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“…This was to help ensure that all students were able to show their problem-solving strategy and ability because they had the knowledge needed for application of strategies. Upon completion, the students' retention of content specific medical knowledge was tested [13], [16], [28].…”

Section: Methodsmentioning

confidence: 99%

Cognitive Problem Solving Patterns of Medical Students Correlate with Success in Diagnostic Case Solutions

et al. 2013

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ContextProblem-solving in terms of clinical reasoning is regarded as a key competence of medical doctors. Little is known about the general cognitive actions underlying the strategies of problem-solving among medical students. In this study, a theory-based model was used and adapted in order to investigate the cognitive actions in which medical students are engaged when dealing with a case and how patterns of these actions are related to the correct solution.MethodsTwenty-three medical students worked on three cases on clinical nephrology using the think-aloud method. The transcribed recordings were coded using a theory-based model consisting of eight different cognitive actions. The coded data was analysed using time sequences in a graphical representation software. Furthermore the relationship between the coded data and accuracy of diagnosis was investigated with inferential statistical methods.ResultsThe observation of all main actions in a case elaboration, including evaluation, representation and integration, was considered a complete model and was found in the majority of cases (56%). This pattern significantly related to the accuracy of the case solution (φ = 0.55; p<.001). Extent of prior knowledge was neither related to the complete model nor to the correct solution.ConclusionsThe proposed model is suitable to empirically verify the cognitive actions of problem-solving of medical students. The cognitive actions evaluation, representation and integration are crucial for the complete model and therefore for the accuracy of the solution. The educational implication which may be drawn from this study is to foster students reasoning by focusing on higher level reasoning.

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Using electronic flashcards to promote learning in medical students: retesting versus restudying

Cited by 85 publications

References 41 publications

Retention of Knowledge and Clinical Skills by Medical Students: A Pro-spective, Longitudinal, One-Year Study Using Basic Pediatric Cardiology as a Model

Retention of Knowledge and Clinical Skills by Medical Students: A Pro-spective, Longitudinal, One-Year Study Using Basic Pediatric Cardiology as a Model

Knowledge is not enough to solve the problems – The role of diagnostic knowledge in clinical reasoning activities

Cognitive Problem Solving Patterns of Medical Students Correlate with Success in Diagnostic Case Solutions

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