Abstract

IntroductionKnowledge, once acquired, degrades over time. Exams that contain questions related to previously acquired knowledge (‘retrieval practice questions’) may promote retrieval practice and spaced learning, and subsequently prevent knowledge loss. To investigate this hypothesis, we compare the score of retrieval practice questions to regular questions in exams of a two-year (bio)medical study program.MethodsThe two-year “Mechanisms of Health and Disease”-program for biomedical sciences and medical students in Nijmegen (the Netherlands) contains 14 spaced exams of 80 questions each. The percentages of correct-, false-, and non-answers were compared between regular questions and retrieval practice questions. Using Pearson correlations between question scores and exam scores (RiT-values), the impact of retrieval practice questions on the internal consistency of exams was determined. Mixed model analyses determined changes in outcomes across time.ResultsAnalysis of 2006 regular questions and 1728 retrieval practice questions revealed a significantly higher percentage of correct and false answers, and a significantly lower percentage of non-answers, in retrieval practice questions versus regular questions (all P < 0.05). Scores did not change across time. RiT-values were slightly lower in retrieval practice questions, with a small inverse trend across time.ConclusionOur data indicate preservation of knowledge, possibly related to retrieval practice and/or spaced learning. Although the RiT-values of retrieval practice questions were slightly lower than those of regular questions, the discriminative capacity was well within acceptable range. These data highlight the potency of retrieval practice questions to prevent knowledge decrement, without altering exam quality.

Highlights

  • IntroductionExams that contain questions related to previously acquired knowledge (‘retrieval practice questions’) may promote retrieval practice and spaced learning, and subsequently prevent knowledge loss

  • retrieval practice questions (RPQs) had fewer respondents than regular questions (RQs) (P < 0.001). %Percentage of correct answers (Cor) and %Percentage of false answers (False) were significantly higher in RPQs compared to RQs (P < 0.05 and P < 0.001, respectively)

  • The exam set-up warrants caution in interpreting the percentage of correct answers, because students were allowed to leave questions open. This option prevents ‘correction for guessing’, as an incorrect answer leads to subtracting points from the exam score. We found that both the percentage of correct and false answers are increased in RPQs, which logically coincides with a decline in the percentage of non-answer (%Percentage of non-answers (Open))

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Summary

Introduction

Exams that contain questions related to previously acquired knowledge (‘retrieval practice questions’) may promote retrieval practice and spaced learning, and subsequently prevent knowledge loss. To investigate this hypothesis, we compare the score of retrieval practice questions to regular questions in exams of a two-year (bio)medical study program. One of the main goals of education is the retention of (newly attained) knowledge. An effective way to achieve knowledge retention is repetitively reviewing study material on multiple occasions [1, 2]. Most educational programs examine students’ knowledge material once or twice only. The rate of knowledge loss, referred to as the ‘forgetting curve’, was first documented by Ebbinghaus in 1913 (Appendix 1) and the presence of this phenomenon has been replicated on numerous occasions, including under various conditions [3]

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