Conceptualising spaced learning in health professions education: A scoping review

Abstract

Objectives To investigate the definitions and applications of ‘spaced learning’ and to propose future directions for advancing its study and practice in health professions education. Method The authors searched five online databases for articles published on spaced learning in health professions education prior to February 2018. Two researchers independently screened articles for eligibility with set inclusion criteria. They extracted and analysed key data using both quantitative and qualitative methods. Results Of the 2972 records retrieved, 120 articles were included in the review. More than 90% of these articles were published in the last 10 years. The definition of spaced learning varied widely and was often not theoretically grounded. Spaced learning was applied in distinct contexts, including online learning, simulation training and classroom settings. There was a large variety of spacing formats, ranging from dispersion of information or practice on a single day, to intervals lasting several months. Generally, spaced learning was implemented in practice or testing phases and rarely during teaching. Conclusions Spaced learning is infrequently and poorly defined in the health professions education literature. We propose a comprehensive definition of spaced learning and emphasise that detailed descriptions of spacing formats are needed in future research to facilitate the operationalisation of spaced learning research and practice in health professions education.

Spaced education and student learning: Results from a medical school

“…As medical students usually adopt assessment-oriented strategic learning, 11 the knowledge and skills imparted are either inadequately acquired or quickly forgotten, and do not promote lifelong learning or guide them to improve patient-care decisions. [4][5][6] This could be attributed to a medical education curriculum approach where the responsibility lies with the student to integrate discipline-based science content/ knowledge with disease-focused information from patient encounters. 12 This disconnect stresses the need for simple, efficacious and reproducible techniques that supplement and reinforce initial learning in order to develop professionally competent physicians.…”

“…1 Studies indicate that basic knowledge and skills acquired as medical students are largely forgotten in routine patient care, and this contributes to poor patient outcomes. [2][3][4][5] For example, when the retention of basic sciences course content was assessed, nearly 85% of the students fell below the minimal level of competency at the start of their second year. 2 Similar results were also reported in paediatrics, where more than half of the paediatric core curricular content was forgotten a year after summative assessment.…”

“…[6][7][8] Spaced education programmes apply the merits of the spacing effect, where students score higher when studying or testing is distributed over time rather than focused on a single learning opportunity. 4,6,7 Furthermore, active retrieval of information/knowledge from memory, when recalled through tests or quizzes, is much more effective than re-reading, as it makes the memory trace more enduring: classically, this is called retrieval practice or the testing effect. 6,8 Our study represents a convergence of optimised spaced learning and test-enhanced learning, using multiple-choice tests to assess the impact on learning and retention.…”

<p>Use of an Adaptive e-Learning Platform as a Formative Assessment Tool in the Cardiovascular System Course Component of an MBBS Programme</p>

“…Adapted Spaced Learning is used as a fundamental technique in Firecracker's adaptive learning platform, and the platform also utilises several other wellestablished principles of learning to improve students' academic performance and long-term retention of memory (Appendix 1). 20 A recent scoping review conducted by Versteeg et al (2020) 21 showed that online spaced learning had been widely used in health profession education. 13,[22][23][24][25][26] Based on the findings, the authors proposed the following comprehensive definition of spaced learning: 21 The objectives of this study were to: (a) determine the usage rates of Firecracker, (b) examine the performance of Firecracker formative quizzes, (c) identify the correlation between Firecracker use and performance with that of performance at summative course assessments, and (d) assess student satisfaction with Firecracker usage.…”

“…Adapted Spaced Learning is used as a fundamental technique in Firecracker’s adaptive learning platform, and the platform also utilises several other well-established principles of learning to improve students’ academic performance and long-term retention of memory ( Appendix 1 ). 20 A recent scoping review conducted by Versteeg et al (2020) 21 showed that online spaced learning had been widely used in health profession education. 13 , 22–26 Based on the findings, the authors proposed the following comprehensive definition of spaced learning: Spaced learning involves [specified] educational encounters that are devoted to the same [specified] material, and distributed over a [specified] number of periods separated by a [specified] interstudy interval, with a [specified] learning outcome after a [specified] retention interval 21 …”