Digital flashcards and medical physiology performance: a dose-dependent effect

Abstract

Use of digital flashcards promotes active-recall, spaced-repetition and self-assessment academic principles. This work explores the association and dose-dependent effect of this study method and locomotor (LP) and cardiovascular physiology (CP) grades. A single-faculty cohort study of medical LP and CP students was conducted, and 155 and 676 flashcards (respectively) were created through Moodle®. An exploratory analysis examined three exam results (2019), and a confirmatory study used a fourth exam (2021) in another CP cohort. Of 685 students enrolled, 558 participated in the exploratory analysis - 319 (69%) for LP, and 311 (84%) for CP, of which 203 LP and 267 CP students were flashcard users. Median grades were higher among flashcard users, and the number of cards reviewed was positively correlated with grades (r=0.275 to 0.388 for LP and r=0.239 to 0.432 for CP, p<0.001). Multiple linear regression models confirmed a positive dose-dependent association between results and the number of flashcards studied - for every 100 LP cards reviewed, exam grades increased 0.44-0.75 on a 0-20 scale range ( p<0.001), and for every 1000 CP flashcards, results raised 0.81-1.08 values ( p<0.05). These findings were confirmed in the 2021 CP cohort of 269 participants, of whom 67% were flashcard users. Digital flashcards' revision has a consistent positive dose-dependent association on LP and CP grades.