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Repetition is the Mother of All Learning

Boosting the Retention of Learning

Any instructor, particularly those in content-rich medical curricula, has seen the rapid decay of recall of information that has been the focus of prior study AND examination.  Having taught pharmacology in a curricula with short (1 week) practical clinically focused rotations that immediately followed an 8-week didactic lecture-base course in pharmacology, I’ve heard students claim ignorance about a topic they were examined on only a couple of weeks earlier!  

There are several possible reasons for this clearly frustrating result: 1) the vast amount of raw information to learn, 2)  lecture-based didactic instruction that doesn’t engage enough active learning, and/or 3) the lack of student (with faculty encouragement) employing strategies for longterm retention. 

 Indeed, when I graduated from veterinary school 40 years ago, the halflife of medical information was 7 years. Now, it is 70 days….not even a semester! So, today’s overwhelmed students need to be encouraged to develop different learning strategies.

One of the goals of the instruction itself should be to encourage strategies for longterm retention, and yet have expectations of students that span beyond an 8-week lecture course to their entire year of instruction, 4 years of instruction, and beyond.   So, at VetMedAcademy, we hope to provide some tools toward this end.  By encouraging and providing short video-based presentations coupled with formative quizzes with immediate feedback, we suggest that such tools can be used for primary learning, or as the student claiming ignorance about a topic they have previously encountered, a succinct way to review.

Every learning module seeks to include deeper reading (articles, textbooks) and clinical case analyses for deeper understanding.  Clearly these strategies seek to engage the learner in more personal active learning, and we encourage them as best practices. However, most of those approaches require significant faculty time to employ and evaluate, and are often best used as summative experiences.  

So, is there any value in using machine-graded (multiple choice, fill-in-the-blank, matching) quizzes that can be easily administered on a learning management system?  These too often tend to be the nature of our summative in-class examinations, simply because they are easier to grade, and generate statistics for discriminating student performance (grades).

A recent LearnDash blog post by Laura Lynch points out that while successful recall is essential for learning, even the prior act of guessing about an answer improves performance later on.  She also points out that the format of questions for formative assessment doesn’t seem to make a difference in later performance.  That means that even automated machine-graded quizzes with feedback can accomplish advances in later retrieval for the student. Lowering the stakes with formative testing helps a student evaluate their test-taking intuition by learning when a “guess” was right and when it was wrong, and why. So, by creating these cycles of micro-learning, formative assessment and repeat if necessary, we propose that the student can self-engage in strategies for longer term retention.

Reference: Lynch, Laura, LearnDash Blog, January 28,2020: https://www.learndash.com/using-retrieval-practice-to-boost-learning-retention/