Theodore E. Woodward Award: spare me the PowerPoint and bring back the medical textbook.

A tutorial for 4(th) year medical students revealed absent long-term retention of microbiology and infectious disease facts taught during the 2(nd) year. Students were suffering from the Ziegarnik effect, the loss of memory after completion of a task. PowerPoint lectures and PowerPoint notes combined with multiple-choice questions may have encouraged this outcome; this teaching format was also associated with minimal use of the course textbook. During the subsequent year, active learning techniques, Just-in-Time Teaching (JiTT) and Peer Instruction (PI) were used, and instructors specifically taught from the textbook. Essays and short answer questions were combined with multiple-choice questions to encourage understanding and recall. Performance on the National Board Shelf exam improved from the 59(th) percentile (2002-2004) to the 83(rd) percentile (2005), and textbook use increased from 1.6% to 79%. This experience demonstrates that strategies incorporating active learning and textbook use correlate with striking improvement in medical student performance.