The importance of seeing the patient: test-enhanced learning with standardized patients and written tests improves clinical application of knowledge

Abstract

Previous research has shown that repeated retrieval with written tests produces superior long-term retention compared to repeated study. However, the degree to which this increased retention transfers to clinical application has not been investigated. In addition, increased retention obtained through written testing has not been compared to other forms of testing, such as simulation testing with a standardized patient (SP). In our study, 41 medical students learned three clinical topics through three different learning activities: testing with SPs, testing using written tests, and studying a review sheet. Students were randomized in a counter-balanced fashion to engage in one learning activity per topic. They participated in four weekly testing/studying sessions to learn the material, engaging in the same activity for a given topic in each session. Six months after initial learning, they returned to take an SP test on each topic, followed by a written test on each topic 1 week later. On both forms of final testing, we found that learning through SP testing and written testing generally produced superior long-term retention compared to studying a review sheet. SP testing led to significantly better performance on the final SP test relative to written testing, but there was no significant difference between the two testing conditions on the final written test. Overall, our study shows that repeated retrieval practice with both SPs and written testing enhances long-term retention and transfer of knowledge to a simulated clinical application.

Tester og testtilbakemeldinger som direkte bidragsytere til dypere læring blant studenter

“…Enda mer lovende, sett med akademiske øyne, er studier som indikerer at testing gir bedre overføring av laert kunnskap til nye kontekster, sammenlignet med repetert lesing (f.eks. Butler, 2010;Carpenter, 2012;Larsen, Butler, Lawson & Roediger, 2012). Det er imidlertid verdt å på peke at mange studenter også kan oppnå godt laeringsutbytte gjennom repetert lesing, og at utbytte av lesing varierer blant studenter (f.eks.…”

Test-Enhanced Learning in an Immunology and Infectious Disease Medicinal Chemistry/Pharmacology Course

“…Test-enhanced learning has been used to promote learning and long-term knowledge retention in medical, 15,25,26 dental, 27,28 and chemistry/science courses. 23,[29][30][31] Therefore, pharmacy education could be a logical extension for this approach, given the overlapping similarities of material and the need for long-term knowledge retention in pharmacy education.…”

The effects of test-enhanced learning on long-term retention in AAN annual meeting courses

“…Studies using medical students, residents, middle school students, and older adults have all shown benefits in knowledge retention using this technique. 6,[10][11][12][13][14] However, the effects of test-enhanced learning have not been investigated in CME settings.…”

“…We anticipated that based on these attendance trends we would be able to recruit an adequate number of participants to achieve meaningful results based on the sample sizes required in previous studies. 6,10,11 All preregistered course participants were eligible for the study. If participants had previously opted out of receiving surveys from SurveyMonkey.com or did not have a valid e-mail address, they were not included in the number of individuals invited to participate in the study.…”

“…These findings are consistent with a growing body of evidence that testenhanced learning consistently produces superior retention over the long run. 6,[10][11][12][13][14] The test-enhanced learning literature suggests that to maximize the mnemonic effects of testing, the following 5 principles should be followed: (1) tests should arise from educational objectives, (2) questions should require the generation of answers rather than the recognition of answers, (3) testing should allow for repeated retrieval practice, (4) repeated tests should be adequately spaced so as to require effortful Table 3 Average numbers of times participants read review items and quiz answers (7) 17 (18) 32 (15) 46 (6) 14 (12) 24 (13) 37 (8) 13 (19) Child neurology (n 5 3) 26 (19) 41 (23) 15 (19) 32 (8) 44 (14) 12 (21) 30 (3) 36 (5) 6 (6) Average (n 5 35) 37 (15) 55 (19) 19 (18) 39 (15) 46 (15) 7 (17) 35 (13) 44 (17) 9 (17) retrieval, and (5) feedback should be provided after each test. 17 Our testing regimen incorporated these principles.…”