Long-term Knowledge Retention Research Articles

Perception and feedback of medical students about teaching methods in anatomy

Student’s feedback is a useful basis for modifying and improving medical education. Through feedback we can identify areas of strength and weakness of teaching methodology. More emphasis is being placed on student centred, integrated, and problem based, clinically relevant teaching and learning. To find out the Perception and Feedback of Medical Students about Anatomy Teaching, Identify methods used to teach Anatomy, Identify those methods that are demonstrated to enhance knowledge retention in Anatomy, either short-term or long-term and what factors, other than the teaching methods, affect long-term knowledge retention in Anatomy. This cross-sectional, descriptive study was conducted in the form of an anonymous survey in a Medical College of Bareilly, U.P. India. Medical students belonging to the 3rd, 5th and 7th semesters were participating in this study. A questionnaire was circulated amongst them during college hours. The questions in the questionnaire were based on the course content, methods of teaching, quality of teaching, teaching tools, mode of assessment of students, and suggestions to improve the quality of the curriculum in relation to gross anatomy. In present study 91.75% (total 367 students out of 400) students responded. Most of the students were satisfied with the coverage of content (41.27%), methods of teaching (44.93%), quality of Teaching (45.47%), tools used in teaching (39.33%) and mode of assessment (44.16%). Learning process can be improved by adopting the better teaching methods; latest teaching tools along with interactive teaching sessions between students and faculty obtained by student’s feedback for anatomy teaching.

P095: Bridging knowledge gaps in anaphylaxis management through a video-based educational tool

Introduction: Cases of anaphylaxis in children are often not appropriately managed by caregivers. We aimed to develop and to test the effectiveness of an education tool to help pediatric patients and their families better understand anaphylaxis and its management and to improve current knowledge and treatment guidelines adherence. Methods: The GEAR (Guidelines and Educational programs based on an Anaphylaxis Registry) is an initiative that recruits children with food-induced anaphylaxis who have visited the ED at the Montreal Children's Hospital and at The Children's Clinic located in Montreal, Quebec. The patients and parents, together, were asked to complete six questions related to the triggers, recognition and management of anaphylaxis at the time of presentation to the allergy clinic. Participants were automatically shown a 5-minute animated video addressing the main knowledge gaps related to the causes and management of anaphylaxis. At the end of the video, participants were redirected to same 6 questions to respond again. To test long-term knowledge retention, the questionnaire will be presented again in one year's time. A paired t-test was used to compare the difference between the baseline score and the follow-up score based on percentage of correct answers of the questionnaire. Results: From June to November 2019, 95 pediatric patients with diagnosed food-induced anaphylaxis were recruited. The median patient age was 4.5 years (Interquartile Range (IQR): 1.6–7.4) and half were male (51.6%). The mean questionnaire baseline score was 0.77 (77.0%, standard deviation (sd): 0.16) and the mean questionnaire follow-up score was 0.83 (83.0%, sd: 0.17). There was a significant difference between the follow-up score and baseline score (difference: 0.06, 95% CI: 0.04, 0.09). There were no associations of baseline questionnaire scores and change in scores with age and sex. Conclusion: Our video teaching method was successful in educating patients and their families to better understand anaphylaxis. The next step is to acquire long-term follow up scored to determine retention of knowledge.

Evaluating the Impact of the Laboratory Learning Environment and Use of a Computer‐assisted Learning Resource on Anatomical Knowledge Recall among Undergraduate University Students

Developing lasting knowledge of human anatomy is foundational for students in the health sciences. Anatomy teaching methods are constantly adapting to achieve this goal, despite time and resource limitations. Interventions that target the laboratory environment, such as moving from dissection‐ to prosection‐based teaching or adding computer‐assisted learning resources, are widespread. However, the long‐term effect of such interventions on knowledge retention is not well understood. Accordingly, this study evaluated 1) the influence of the laboratory learning environment (dissection‐ versus prosection‐based) and 2) the impact of a curriculum‐targeted computer‐assisted learning resource on long‐term knowledge recall among non‐medical undergraduate human anatomy students at the University of Guelph. Participants reported their demographic information, approaches to learning in the course, and use of the computer‐assisted learning resource through a combination of online and written surveys. Knowledge recall was assessed through a written test of short‐answer questions administered three months after the course ended. The test included two low‐order questions and two high‐order questions (based on the Blooming Anatomy Tool), which were evaluated using the Structure of the Observed Learning Outcome Taxonomy to yield performance scores. The performance scores were compared between dissection‐ and prosection‐based groups, as well as between low‐ and high‐frequency users of the computer‐assisted learning resource with the Mann‐Whitney U test. Furthermore, multiple linear regression analyses were used to investigate the relationships between 1) the laboratory learning environment and performance and 2) use of the computer‐assisted learning resource and performance, while controlling for students’ approach to learning scores, final grades, and how recently they studied the material. The laboratory environment was not found to influence knowledge recall (p > 0.05). However, high‐frequency users of the computer‐assisted learning resource demonstrated stronger knowledge recall than low‐frequency users (p = 0.003) and use of the resource was strongly positively correlated with performance on high‐order questions (p = 0.014) when controlling for the aforementioned variables. Deep approaches to learning were positively associated with overall knowledge recall ability in both comparisons (p < 0.05). These findings suggest that the dissection‐ and prosection‐based laboratory teaching approaches at the University of Guelph offered equal opportunities for long‐term knowledge retention; however, using the resource more frequently and pursuing a deeper approach to learning in the course may help students develop stronger long‐term knowledge recall abilities. Therefore, supplemental computer‐assisted learning resources can be used as a low‐risk intervention to support cadaver‐based human anatomy education and promote long‐term knowledge retention.

Assessing the Relationship Between Students’ Approaches to Learning, Visuospatial Abilities, and Performance in an Undergraduate Human Anatomy Course

Learning is difficult to quantify. Several metrics for successful student learning have been explored, the most popular of which is academic performance. However, academic performance does not always accurately represent nuanced outcomes such as meaningful learning and skill development, nor is it a successful predictor of long‐term knowledge retention. One metric that has demonstrated alignment with such qualitative learning outcomes is student approach to learning; a framework that evaluates the depth with which students interact with their learning environment and the course content. However, the student approach to learning framework has yet to be adequately investigated for its reliability as a metric for learning in human anatomy, specifically. One measure that has been shown to predict learning achievement in human anatomy is visuospatial ability. Individuals with high visuospatial abilities are typically faster and more successful at performing three‐dimensional anatomy tasks than those with low visuospatial abilities. It has been suggested that this may be due to differences in strategies used for learning by students with high (versus low) visuospatial abilities. Despite this, the degree of correlation between students’ approaches to learning and visuospatial abilities has yet to be investigated. The present study therefore aimed to examine the relationship between students’ approaches to learning, visuospatial abilities, and performance in anatomy to investigate the validity of the student approach to learning framework as an alternative metric to evaluate anatomy learning. Physical Therapy, Occupational Therapy, and Kinesiology students (n = 35) completed a Mental Rotations Test and Revised 2‐factor Study Process Questionnaire after the end of their first anatomy course. Responses and final course grades were examined using regression analyses to detect their degrees of correlation. We hypothesized that visuospatial ability would correlate positively with both anatomy performance and deep approach to learning scores and have a negative correlation with surface approach to learning scores. However, no significant correlations were found between visuospatial ability and deep or surface approach to learning scores at p ≤ 0.05. Anatomy performance was positively correlated with deep approach to learning scores (β = 0.427, p = 0.02) and negatively correlated with surface approach to learning scores (β = ‐0.704, p < 0.01) but had no significant correlation with visuospatial ability at p ≤ 0.05. The data suggest that visuospatial ability does not significantly influence students' approaches to learning; however, additional research on larger populations is required to explore these relationships further.

Using Simulation to Evaluate Nurse Competencies.

A multimodal nursing pedagogy utilizing simulation was incorporated into annual nurse competencies at a 465-bed academic medical center to translate into practice the required surveillance of a potentially septic patient and the necessary clinical decision-making. Pretest/posttest was used to determine knowledge retention from simulation. Nurses' sepsis knowledge following simulation was improved. Simulation can provide long-term knowledge retention of sepsis for application into clinical practice and be a viable option for competency assessment for professional nurses.

Collaborative Testing in Medical Education: Student Perceptions and Long-Term Knowledge Retention.

Collaborative testing blends collaborative learning and assessment, engaging small groups of students in answering exam questions as a team. Previous studies have shown that collaborative testing promotes increased student performance and short-term knowledge retention over individual testing alone. In this mixed-methods study, we examined the effects of collaborative testing on preclinical medical students' long-term retention of basic science knowledge, as well as students' approaches and perceptions of collaborative testing. Small groups of students consecutively experienced two conditions after their individual exams: collaborative testing, where they answered half of the exam questions together, and group exam review, where they discussed the other half of the questions with answers provided. Eight months later, students individually took a post-test that included a subset of the questions they had previously encountered in the context of collaborative testing and a subset of questions from group exam review. We found that both post-test performance and knowledge retained from initial individual exam to post-test were significantly higher for the collaborative testing condition. Qualitative findings suggest that knowledge retention was enhanced by collaborative processes and repeated knowledge retrieval elicited by collaborative testing. While students were appreciative of opportunities to discuss ideas and work as a team, many expressed negative opinions about not being certain of correct answers and experiencing interpersonal conflict in collaborative testing. We discuss implications of these findings to enhance design of collaborative testing opportunities and learning environments that support knowledge retention, productive views of authority and certainty of knowledge, and effective collaborative practice.

Three-dimensional Virtual Reality as an Innovative Teaching and Learning Tool for Human Anatomy Courses in Medical Education: A Mixed Methods Study.

IntroductionPoor knowledge retention is one reason for medical student attrition in learning and has been a huge concern in medical education. Three-dimensional virtual reality (3D-VR)-based teaching and learning in medical education has been promoted to improve student learning outcomes. This study aimed to determine the effectiveness of 3D-VR in knowledge retention in human anatomy courses as compared to traditional teaching methods among medical students.MethodsA convergent mixed methods design was utilized to evaluate learning outcomes in terms of short- and long-term knowledge retention scores among students using 3D-VR and those using traditional models and to describe students’ experiences and views of the use of 3D-VR as a teaching and learning tool.ResultsMale students who used the 3D-VR tool had significantly higher short- and long-term knowledge scores than males who used the traditional methods. Meanwhile, females who used traditional methods showed significantly higher short-term knowledge scores than females who used 3D-VR.ConclusionMedical students described 3D-VR as a learning tool with a great deal to offer for learning human anatomy as compared to traditional methods. Therefore, we recommend adding the use of 3D-VR in the anatomy curriculum. However, several 3D-VR limitations were also identified, which may hinder its utilization for teaching and learning. These concerns must be addressed before 3D-VR tools are considered for implementation in medical education human anatomy courses.

Large-scale application of case-based learning for teaching medical biochemistry: a challenging experience with positive impacts

With the introduction of integrated approach in the medical curriculum, there is a need to teach basic sciences in a way relevant to real clinical scenarios. The aim of this study is to investigate the feasibility of case-based learning (CBL) for teaching of medical biochemistry to a large number of medical students. It also evaluates both the students’ and faculty members’ perception of this approach. CBL was introduced in teaching medical biochemistry in the Neuroscience block for the second-year medical students. This study’s students were from two consecutive academic years (n = 721 and 769). Four clinical cases were prepared. Students were divided into subgroups, each having one CBL session every 2 weeks. Students were encouraged to work together to understand the given clinical scenario by building on past knowledge obtained through other teaching modalities and new knowledge acquired during the session. A pretest was administered at the beginning of the session, and an identical posttest administered at the end of the session. Perception of both the students and facilitators of the CBL-teaching approach was evaluated using end-of-block questionnaires. In both studied academic years, students got higher scores in posttest compared to pretest scores with a statistically significant difference of the paired scores (P < 0.001). Analysis of the students’ questionnaire demonstrated that most students positively perceived the CBL approach, with a feeling that CBL has helped them learning the biochemistry concepts. Likewise, analyzing staff questionnaire revealed staff’s positive attitude toward the impact of CBL in teaching biochemistry on the students and on themselves. The current work suggests that CBL is both feasible and efficient to be applied for teaching medical biochemistry on a large scale. It is positively perceived by both students and teaching staff. Future work is still needed to solve certain challenges such as increasing work load on the faculty members and to test the impact of this teaching modality on long-term retention of knowledge.

Body Painting of the Horse and Cow to Learn Surface Anatomy.

Gross anatomy is considered one of the most challenging subjects in teaching veterinary medicine. The use of body painting is reported in teaching surface human anatomy, but such reports are scarce in veterinary medicine. The aim of this study was to describe a practical session for teaching surface anatomy using body painting with second-semester students of veterinary medicine. Two practical sessions using live animals (equine and bovine) were offered with a focus on the locomotor and nervous systems and splanchnology. Students believed that the body painting sessions helped them to understand the localization of structures, promoting long-term retention and integration of knowledge, and to approach large animals with more self-confidence. Forty-nine students took three short theoretical and practical exams: a pre-test on splanchnology (Q1), an immediate post-test on splanchnology (Q2), and a post-test after 7 weeks on the locomotor and nervous systems (Q3). Correct answers for theoretical Q1 and Q2 were statistically different (2.04 and 3.11 out of 5, respectively; p < .001), and higher scores were found for Q3 compared with Q1 (2.49 and 1.02 out of 5, respectively). The most common error observed in practical Q1 was underestimation of the real size of organs such as lungs, rumen in cattle, and cecum in horses. The results showed that body painting sessions improved learning of anatomical concepts and could serve as a bridge between cadaver anatomy and living animal anatomy. More body painting sessions could be included in other semesters of the veterinary medicine curriculum to better integrate anatomy knowledge.

A Brief Educational Intervention Enhances Basic Cancer Literacy Among Kentucky Middle and High School Students

Kentucky experiences the highest overall cancer incidence and mortality rates in the USA with the greatest burden in the eastern, Appalachian region of the state. Cancer disparities in Kentucky are driven in part by poor health behaviors, poverty, lack of health care access, low education levels, and low health literacy. Individuals with inadequate health literacy are less likely to participate in preventive measures such as obtaining screenings and making healthy lifestyle choices, thus increasing their chances of developing and dying from cancer. By increasing cancer literacy among youth and adults, it may be possible to decrease cancer disparities across Kentucky. This study aimed to establish connections with middle and high schools in Kentucky that would facilitate pilot implementation of a brief cancer education intervention and assessment of cancer health literacy among these student populations. A baseline pretest cancer literacy survey consisting of 10 items was given to 349 participants, followed by the delivery of a cancer education presentation. Immediately following the presentation, participants were given a posttest with identical items to the pretest. Participants were primarily Caucasian (89.4%), female (68.7%), and in 10th through 12th grade (80.5%). Significant (p < 0.0001) increases in both average and median percent of correctly marked items were observed between the pretest and posttest (average, pretest = 56% versus posttest = 85%; median, pretest = 60% versus posttest = 90%). The scores for all individual items increased after the brief intervention. The results demonstrated a significant increase in cancer literacy levels immediately after the pilot educational intervention. We suggest that it may be possible to improve cancer literacy rates in Kentucky by integrating cancer education into middle and high school science and/or health education curricula. This could ultimately drive changes in behaviors that may help lower cancer incidence and mortality rates. Plans for future interventional studies measuring long-term cancer knowledge retention and resultant behavioral changes among middle and high school students as well as the feasibility of integrating cancer education into middle and high school curricula are also discussed.

Compu Castel: An Instructional Tool for Teaching Firewall Concepts

Firewall is an essential device in every computer network. It needs skillful professionals to accurately configure its rules for proper functioning. To help prepare these professionals, university level students need more engaging and attractive interactive tools to develop their skills. For this regard, this paper presents the design, implementation and evaluation of "Compu Castel" educational video game that teaches firewall concepts. In addition to evaluating the impact of educational game on short-term knowledge acquisition, both, mid-term (after 2 months) and long-term (after 5 months) knowledge retention is analyzed. The results confirm that educational games affect positively short-term knowledge acquisition compared with traditional text based methods. Moreover, educational games enhance knowledge retention for mid-term and long-term periods.

The Use of Clinical PBL in Primary Care in Undergraduate Medical Schools

Abstract: Introduction: Problem-based learning (PBL) is a collaborative student-centered learning method for small groups, based on the mobilization of previous knowledge and on critical reasoning for problem solving. Although it has been used predominantly in the classroom, when applied in clinical studies, PBL can increase the intrinsic motivation and long-term knowledge retention. In addition, Clinical PBL represents a more effective option to learn from practice considering the students’ overload in clinical clerkships in the Unified Health System (UHS). This study aimed to assess the students’ perception of a Clinical PBL model implemented in Primary Health Care (PHC) clerkships during the first four years of the Medical Course at the University of Ribeirão Preto (UNAERP) in 2017. Method: The primary outcome was assessed by the DREEM (Dundee Ready Educational Environment Measure) tool, which contains 50 items distributed in five dimensions. The questionnaire was applied to 374 medical students, corresponding to 78% of the total number of medical students from the first to the fourth year. Results: For most of the evaluated items, the students’ perceptions were “positive”, including the dimensions “Perception of Teachers”, “Perception of Academic Results” and “Perception of the General Environment”. For the dimensions “Perception of Learning” and “Perception of Social Relationships” the evaluation was “more positive than negative”. The DREEM total score was 124.31, corresponding to 62.15% of the maximum score, which indicates a perception that is “more positive than negative” regarding the Clinical PBL. The internal consistency given by Cronbach’s alpha was 0.92. Conclusion: The use of Clinical PBL in PHC qualifies learning from practice, is well accepted by medical students and offers a useful option to the students’ overload in the clinical clerkship during the first four years of the Medical School.

The Use of Clinical PBL in Primary Care in Undergraduate Medical Schools

Abstract: Introduction: Problem-based learning (PBL) is a collaborative student-centered learning method for small groups, based on the mobilization of previous knowledge and on critical reasoning for problem solving. Although it has been used predominantly in the classroom, when applied in clinical studies, PBL can increase the intrinsic motivation and long-term knowledge retention. In addition, Clinical PBL represents a more effective option to learn from practice considering the students’ overload in clinical clerkships in the Unified Health System (UHS). This study aimed to assess the students’ perception of a Clinical PBL model implemented in Primary Health Care (PHC) clerkships during the first four years of the Medical Course at the University of Ribeirão Preto (UNAERP) in 2017. Method: The primary outcome was assessed by the DREEM (Dundee Ready Educational Environment Measure) tool, which contains 50 items distributed in five dimensions. The questionnaire was applied to 374 medical students, corresponding to 78% of the total number of medical students from the first to the fourth year. Results: For most of the evaluated items, the students’ perceptions were “positive”, including the dimensions “Perception of Teachers”, “Perception of Academic Results” and “Perception of the General Environment”. For the dimensions “Perception of Learning” and “Perception of Social Relationships” the evaluation was “more positive than negative”. The DREEM total score was 124.31, corresponding to 62.15% of the maximum score, which indicates a perception that is “more positive than negative” regarding the Clinical PBL. The internal consistency given by Cronbach’s alpha was 0.92. Conclusion: The use of Clinical PBL in PHC qualifies learning from practice, is well accepted by medical students and offers a useful option to the students’ overload in the clinical clerkship during the first four years of the Medical School.

Evaluating Effectiveness of Online Learning Modules in Pediatric Environmental Health Education.

Content and training about pediatric environmental health are lacking in healthcare professionals' education. In an initiative to improve pediatric environmental health education, the Pediatric Environmental Health Specialty Unit (PEHSU) program offers free, interactive, web-based ("eLearning") modules on environmental health topics. The aim of this study is to determine the effectiveness of PEHSU eLearning modules in increasing knowledge about pediatric and reproductive environmental health. This is a retrospective analysis of 994 users who had completed at least one of the 12 PEHSU eLearning modules and its associated pre-test and post-test scores between March 2016 and November 2018. Users who completed modules between March 2016 and April 2018 received a 6-month follow-up survey to assess the impact of the knowledge gained on their clinical practice. A wide range of clinical professionals and nonclinical professionals utilized and completed the PEHSU eLearning modules. For all users, post-test scores were significantly higher than pre-test scores, with an increase of 30.55% ± 22.37 (paired t-test, p < 0.0001), after completion of eLearning modules. PEHSU eLearning modules are effective at increasing environmental health knowledge of clinical and nonclinical professionals. Further studies are needed to determine long-term knowledge retention and clinical impact.

An 89% solution adoption rate at a two-year follow-up: evaluating the effectiveness of an animated agricultural video approach

ABSTRACT Securing the adoption of scalable agro-educational information and communication technology (ICT) solutions by farmers remains one of the international development community’s most elusive goals – in part due to two key gaps in the data: (1) limited comparisons of competing knowledge-delivery methods, and (2) few to no follow-ups on long-term knowledge retention and solution adoption. Addressing both of these gaps, this follow-up study measures farmer knowledge retention and solution adoption two years after being trained on an improved postharvest bean storage method in northern Mozambique. The results found animated-video knowledge delivery at least as effective as a traditional extension approach for knowledge retention (97.9%) and solution adoption (89%). As animated video can more cost-effectively reach the widest – even geographically isolated – populations, it readily complements extension services and international development community efforts to secure knowledge transfer and recipient buy-in for innovations. Implications and future research for adult learning are also discussed.

Long-Term Knowledge Retention after Peer-Assisted Abdominal Ultrasound Teaching: Is PAL a Successful Model for Achieving Knowledge Retention?

Diagnostic ultrasound has a crucial importance in clinical settings, especially in intensive care medicine where bedside ultrasound has become indispensable. Medical students as well as residents therefore have a strong interest in learning this useful skill. Since staff resources are limited, more and more universities are using student tutors in a peer-assisted learning concept (PAL) to teach medical students early in their training. To date, there is very sparse data about knowledge retention after peer-assisted teaching. The aim of this study was to evaluate whether PAL is a suitable method for teaching complex skills like abdominal ultrasound and to evaluate whether students do achieve adequate long-term knowledge retention after peer-assisted teaching. A total of 40 volunteer 3rd to 5th year students were randomly assigned to a basic abdominal ultrasound course in small training groups of 5 persons each. Participants were evaluated using a pre-post-test design by a validated objective structured clinical examination (OSCE) before and immediately after the course. To measure the retention of knowledge, 15 former participants were randomly selected to repeat the OSCE assessment after one year. All groups showed a significant improvement in practical skills and knowledge gain after the training with mean values of 13.1 for pre-test compared to 83.5 (maximum 100 points) for post-test (p < 0.001). The overall score achieved after one year was 78.7 and did not significantly differ from the post-test result. PAL is effective for teaching abdominal ultrasound. Students were able to accomplish a satisfactory level of ultrasound skills. We further demonstrated that PAL can assure long-term knowledge retention.

The Effects of Content Delivery Methods on Ultrasound Knobology and Image Quality Recognition Training in First-Year Veterinary Students

As new technologies are incorporated into the practice of veterinary medicine, it is imperative we utilize the most effective and impactful content delivery methods. Ultrasound technology has become more affordable and compact for veterinary hospitals, leading to easier incorporation into practice. This study compares three methods of delivering ultrasound knobology content to first-year veterinary students at Texas A&M University College of Veterinary Medicine and Biomedical Sciences. In a prospective study, first-year veterinary students were randomly selected to receive one of three content delivery methods: self-directed active learning (SDL), in-person instructor demonstration, or online module instruction. Knowledge acquisition was assessed using a 10-question quiz for short-term understanding followed by a 10-question quiz after a 6-week period to assess long-term knowledge retention. Student demographics were analyzed using the Chi-square test. Quiz scores were analyzed between groups using Kruskal-Wallis tests followed by Dunn's post-tests for multiple comparisons. Values of p ≤ .05 were considered significant. On the short-term and retention quiz questions, students participating in SDL scored significantly higher (10 [5-10]) than those receiving in-person instructor demonstration (9 [3-10] p = .01 and 8 [2-10] p = .0004, respectively) or the online module instruction training (Group C) (6 [1-10] p < 0.0001 and 8 [4-10] p < .001, respectively). Based on quiz scores, veterinary students exhibited better ultrasound knobology and image quality recognition proficiency immediately and at 6-weeks following SDL when compared with other content delivery methods. Self-directed learning methods are recommended when teaching ultrasonography to veterinary students.

Can an Online Educational Module Improve Medical Trainee Confidence and Knowledge of Coagulation?

Background: Coagulation has notoriously been a topic that medical trainees find challenging to learn. A lack of understanding around coagulation has led to widespread inappropriate ordering of commonly used coagulation tests, including the prothrombin time (PT) and the activated partial thromboplastin time (aPTT). Despite these tests being validated for specific clinical indications, they are frequently ordered as screening tests in unselected patients, and often ordered together, suggesting a gap in physician understanding of coagulation and appropriate testing. To explore this further, we conducted a root-cause-analysis survey of 10 medical trainees. 70% of the surveyed trainees did not feel comfortable with their knowledge regarding coagulation and the appropriate use of coagulation tests. Trainees attributed their suboptimal knowledge to the manner in which coagulation is taught in training programs. Furthermore, they identified a scarcity of practical resources on coagulation and expressed interest in a web-accessible resource. Methods: We created an educational module on coagulation testing for trainees, available online at www.coagtesting.com. This module was created with the intent of simplifying the teaching of coagulation, with a focus on emphasizing clinically-relevant concepts. The module was evaluated at the University of Toronto with 50 participating medical trainees (11 medical students, 39 internal medicine residents [14 PGY1, 15 PGY2, 10 PGY3 residents]). Participation in our study included completing a validated knowledge pre-quiz on coagulation, completion of the educational module, and then the post-quiz following the module. To assess longer term knowledge retention, participants were asked to repeat the knowledge quiz three months following their initial participation. Our educational intervention was evaluated according to the Kirkpatrick Model, a framework for learning evaluation, with educational outcomes organized into four ranked levels (level 1, reaction; level 2, learning; level 3, behaviour; level 4, results). The primary objective of this study was to determine if the module improves trainee knowledge of coagulation, as indicated by their quiz results (level 2, learning). The secondary objective was to evaluate if the module has an influence on trainee ordering practices as assessed by a follow-up survey (level 3, behaviour). Results: The median pre-module quiz score was 67% (range 24% - 86%) with an increase of 24% to a median post-module quiz score of 91% (range 64% - 100%). Notably, in the pre-module quiz, 94% of trainees overestimated the sensitivity and specificity of the PT and aPTT in detecting a bleeding disorder, and 44% of trainees underestimated the cost of a PT test. 80% of trainees described increased confidence regarding their knowledge of coagulation and the use of coagulation tests following completion of the module. In addition, we have demonstrated sustained knowledge acquisition with a 3-month post-quiz median score of 89% (n=15, range 67%-100%). 100% of trainees who completed the 3-month follow-up survey (n=15) felt that the educational module had a positive influence on their practice and 87% of trainees were more likely to consider the sensitivity, specificity, and cost of a lab test prior to ordering it. In the seven months since the module was launched, it has been completed by over 2,000 unique visitors worldwide, with use in Canada, the United States, the United Kingdom, Australia, France, and Saudi Arabia according to data from our website host. Furthermore, several visitors to the website have re-visited the module multiple times. Conclusion: We have successfully demonstrated a significant increase in trainee knowledge and confidence regarding coagulation and appropriate use of coagulation tests with our educational intervention. Using the expertise of medical educators and incorporating feedback from trainees, we have employed a novel approach to the teaching of coagulation to maximize its approachability and clinical relevance. Our module also incorporates education on the cost of coagulation testing and appropriate use of these tests thus in line with the tenets of Choosing Wisely. The degree to which trainees have been utilizing and re-referring to our educational module worldwide emphasizes the need for this resource and its importance in bridging a large gap in medical training. Disclosures Sholzberg: Novartis: Honoraria; Amgen: Honoraria, Research Funding.

The Effect of Passive and Active Education Methods Applied in Repetition Activities on the Retention of Anatomical Knowledge.

This study examines the long‐term retention of anatomical knowledge from 180 students after various repetition activities. The retention of anatomical knowledge was assessed by multiple‐choice tests at five different points in time: before and after a course in Functional Anatomy, before and after repetition activities that occurred 14 weeks after this course, and 28 weeks after this course to establish long‐term retention. Students were divided into five groups: one without any repetition activity, one with a restricted repetition activity (the multiple‐choice test), and three groups that were offered repetition activities (traditional lecture, e‐learning module, and small group work in the dissection room). During all three repetition activities the same information was conveyed, and this content was not revisited in other courses for the duration of the study. The results showed that students who did not engage in a repetition activity scored significantly lower on the long‐term retention test compared to all other groups (ANCOVA: P = 0.0001). Pair‐wise comparison with estimated means showed that the other four groups, regardless of the type of repeating activity, did not differ in the amount of knowledge they retained during any of the five assessments (P = 0.008, P = 0.0001, P = 0.001, and P = 0.0001, respectively). This study suggests that the type of repetition activity has no effect on knowledge retention both immediately following the activity and in the long term. It is concluded that the repetition of anatomical knowledge in any form is beneficial for students and will likely improve student outcomes in a curriculum that builds on prior knowledge.

Comparison of Rewatching Class Recordings versus Retrieval Practice as Post-Lecture Learning Strategies

Objective. To assess the relative effectiveness of two study strategies, rewatching a recorded lecture and retrieval practice, on Doctor of Pharmacy (PharmD) students' long-term retention of lecture material presented in a pharmacotherapeutics class. Methods. One hundred two first-year pharmacy students were recruited for the study. All students attended two in-class lectures on different topics. The following week, students either re-studied from the recorded lecture on one of the two topics or, on the other topic, retrieved information about class content by responding to the course objectives. Half of the students were quizzed immediately after studying both topics. One week later, all students were required to complete an unannounced quiz to measure long-term retention. Finally, students were surveyed regarding their perceptions of the two learning strategies. Time on task was recorded to assess the efficiency of each learning strategy. Results. The primary outcome was student performance on the unannounced quiz administered one week after restudy of the lecture. No difference in performance was found between students who restudied the recorded lecture versus students who retrieved information about the lecture. However, immediately after restudying the material, students who studied from the recorded lecture performed better than students who retrieved information on the lecture. In terms of efficiency, the retrieval learning method required less time for the same gain in students' long-term retention of knowledge. Conclusions. Testing may be more efficient (ie, cost-effective) for long-term performance. Students who attend class may want to avoid rewatching course recordings in favor of practice testing.