An Evidence-Based Guide for Medical Students: How to Optimize the Use of Expanded-Retrieval Platforms

Abstract

Recommendations have been made for improving medical education based on the available evidence regarding learning. Traditional learning methods in medical education (e.g. reading from textbooks) do not ensure long-term retention. However, expanded-retrieval studying methods have been shown to improve studying efficiency. Using evidence-based practices to optimize an expanded-retrieval platform has the potential to greatly benefit knowledge acquisition and retention for medical students. This literature review was conducted to identify the best practices of expanded-retrieval platforms. Themes within learning that promote knowledge gain and retention include presentation of related categorical information, schema formation, dual-coding, concrete examples, elaboration, changes in text appearance, and interleaving. Presentation of related categorical material together may mitigate retrieval-induced forgetting (RIF). Spaced retrieval helps to reinforce schema formation by solidifying the framework the individual students form when learning the material. Dual-coding improves learning by creating more neural pathways. Multiple concrete examples can be compared by students to see their respective differences, highlighting the true underlying principle. Variation in text appearance is most useful during the initial, short-term inter-study intervals. Interleaving is a theme where different topics are combined in the same study session and is unpopular with students but shown to be successful. Students' subjective competency ratings of new material are largely inaccurate. More in-depth processing and learning methods that give off a sense of lower competency are actually associated with improved long-term retention. Expanded-retrieval platforms should utilize these evidence-based components of learning to increase knowledge gain and retention within all fields of medical education.

Keywords: active learning; anki; evidence-based learning; expanded-retrieval; knowledge acquisition; medical education; optimization; retention; retrieval; spaced repetition.

Figure 1. Article Inclusion Process

Figure 2. Presentation of related information: testing recognition of different concepts within the same field

{{c1::}} is used in spaced repetition programs to add 'Cloze deletions' where the phrase contained in the brackets is hidden for the user to recall.

Figure 3. Schema formation: flashcards can be organized by concepts grouped inside a larger field to allow for the formation of schemas

Figure 4. Dual-coding: both text and images can be used to enhance learning of a topic

{{c1::}} is used in spaced repetition programs to add 'Cloze deletions' where the phrase contained in the brackets is hidden for the user to recall.

Figure 5. Concrete examples: specific examples of concepts elaborated in the previous flashcards can be given

{{c1::}} is used in spaced repetition programs to add 'Cloze deletions' where the phrase contained in the brackets is hidden for the user to recall.

Figure 6. Elaboration: flashcards can be utilized with other resources to consolidate learning

Figure 7. Changes in text appearance: changing the appearance will prevent rote memorization

{{c1::}} is used in spaced repetition programs to add 'Cloze deletions' where the phrase contained in the brackets is hidden for the user to recall.

Figure 8. Interleaving: mixing in unrelated topics can help aid comprehension

{{c1::}} is used in spaced repetition programs to add 'Cloze deletions' where the phrase contained in the brackets is hidden for the user to recall.