Kerfoot B Price, DeWolf William C, Masser Barbara A, Church Paul A, Federman Daniel D
Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA.
Med Educ. 2007 Jan;41(1):23-31. doi: 10.1111/j.1365-2929.2006.02644.x.
Medical knowledge learned by trainees is often quickly forgotten. How can the educational process be tailored to shift learning into longer-term memory? We investigated whether 'spaced education', consisting of weekly e-mailed case scenarios and clinical questions, could improve the retention of students' learning.
During the 2004-5 surgery clerkships, 3rd-year students completed a mandatory 1-week clinical rotation in urology and validated web-based teaching programme on 4 core urology topics. Spaced educational e-mails were constructed on all 4 topics based on a validated urology curriculum. Each consisted of a short clinically relevant question or clinical case scenario in multiple-choice question format, followed by the answer, teaching point summary and explanations of the answers. Students were randomised to receive weekly e-mailed case scenarios in only 2 of the 4 urology topics upon completion of their urology rotation. Students completed a validated 28-item test (Cronbach's alpha = 0.76) on all 4 topics prior to and after the rotation and at the end of the academic year.
A total of 95 of 133 students (71%) completed the end-of-year test. There were no significant differences in baseline characteristics between randomised cohorts. Spaced education significantly improved composite end-of-year test scores (P < 0.001, paired t-test). The impact of the spaced educational e-mails was largest for those students who completed their urology education 6-8 and 9-11 months previously (Cohen's effect sizes of 1.01 and 0.73, respectively).
Spaced education consisting of clinical scenarios and questions distributed weekly via e-mail can significantly improve students' retention of medical knowledge.
实习生所学的医学知识常常很快就被遗忘。如何调整教育过程，使学习转化为长期记忆？我们研究了由每周通过电子邮件发送的病例场景和临床问题组成的“间隔教育”是否能提高学生学习内容的留存率。
在2004 - 2005年外科实习期间，三年级学生完成了为期1周的泌尿外科强制临床轮转，并参与了关于4个泌尿外科核心主题的经过验证的网络教学项目。基于经过验证的泌尿外科课程，针对所有4个主题构建了间隔教育电子邮件。每封邮件都包含一个简短的临床相关问题或选择题形式的临床病例场景，随后是答案、教学要点总结和答案解释。学生在完成泌尿外科轮转后，被随机分配仅接收4个泌尿外科主题中2个主题的每周电子邮件病例场景。学生在轮转前后以及学年末完成了一项经过验证的包含28个项目的测试（克朗巴哈系数α = 0.76），测试涵盖所有4个主题。
133名学生中有95名（71%）完成了年终测试。随机分组的队列之间基线特征无显著差异。间隔教育显著提高了年终综合测试成绩（P < 0.001，配对t检验）。间隔教育电子邮件对那些在6 - 8个月和9 - 11个月前完成泌尿外科教育的学生影响最大（科恩效应量分别为1.01和0.73）。
由每周通过电子邮件分发临床场景和问题组成的间隔教育可以显著提高学生对医学知识的留存率。
