a Department of Pediatrics, Division of Emergency Medicine , Hospital for Sick Children and the University of Toronto , Toronto , Canada.
b Contrail Consulting Services , Toronto , Canada.
Med Teach. 2019 Jul;41(7):756-764. doi: 10.1080/0142159X.2019.1570098. Epub 2019 May 2.
Forgetting curves plot skill decay over time. After exposure to a simulation-based radiograph interpretation learning system, we determined the rate of learning decay and how this was impacted by testing (with and without feedback). Further, we examined the association of initial learning parameters on the forgetting curve. This was a multicenter, four-arm randomized control trial. Medical trainees completed 80 elbow radiographs and a 20-case post-test. Group 1 had no testing until 12 months; Groups 2-4 had testing every 2 months until 12 months. At 6 months, Group 3 testing was feedback-enhanced, while Group 4 had feedback-enhanced testing at 2, 6, and 10 months. There were 106 participants ( = 42 Group 1; = 22 Groups 2 and 3; = 20 Group 4). Group 1 showed an -8.1% learning decay at 12-months relative to other groups. In Groups 2, 3, and 4, there was no significant learning decay (+0.8%), and there were no differences in skill decay between these groups. Initial score and learning curve slope were predictive of retained skill. Learning decay was mitigated by exposure to 20 test cases (with and without feedback) every two months. Initial learning parameters predicted learning retention and may inform refresher education scheduling.
遗忘曲线描绘了技能随时间的衰退情况。在接触基于模拟的放射照片解读学习系统后，我们确定了学习衰退的速度，以及测试（有反馈和无反馈）如何对此产生影响。此外，我们还研究了初始学习参数与遗忘曲线的关联。这是一项多中心、四臂随机对照试验。医学实习生完成了 80 张肘部 X 光片和 20 例后测。第 1 组在 12 个月内不进行测试；第 2-4 组在 12 个月内每 2 个月进行一次测试。在 6 个月时，第 3 组的测试增强了反馈，而第 4 组在 2、6 和 10 个月时增强了反馈测试。共有 106 名参与者（第 1 组 = 42 人；第 2 和 3 组 = 22 人；第 4 组 = 20 人）。与其他组相比，第 1 组在 12 个月时的学习衰退率为-8.1%。第 2、3 和 4 组没有明显的学习衰退（+0.8%），这些组之间的技能衰退没有差异。初始分数和学习曲线斜率可预测保留的技能。每两个月接触 20 次测试案例（有反馈和无反馈）可减轻学习衰退。初始学习参数可预测学习保留情况，可能为复习教育安排提供信息。
