Department of Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Department of Internal Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.
Clin Teach. 2024 Feb;21(1):e13626. doi: 10.1111/tct.13626. Epub 2023 Aug 30.
Accurate electrocardiogram (ECG) interpretation is critical for safe patient care, making this skill a necessary competency for medical school graduation. Improved long-term memory retention with repeated exposure to material is one of the most evidenced-based components of adult learning science. This curricular innovation aimed to determine if implementing spaced repetition and retrieval practice using ECG quizzes during the principal clinical year would improve ECG interpretation skills among medical students enrolled in a Longitudinal Integrated Clerkship (LIC).
The curricular innovation applied the spacing effect and retrieval practice. Cognitive science demonstrates enhanced long-term retention through repeated interval exposure to learned material. Studies of spaced retrieval indicate that memory retention is enhanced through tests involving effortful recall. LIC students in an intervention group were exposed to the spacing effect with periodic ECG quizzes throughout their clinical clerkship year.
The results of the 17-item post-test for 140 students were analysed: LIC intervention, N = 54; block control, N = 62; and LIC control, N = 24. The ANOVA test was significant (p < 0.001). Games-Howell post hoc testing showed that the mean score in the LIC intervention group was significantly higher compared with the LIC control group (p < 0.001) and the block control group (p < 0.001). There was no significant difference between the LIC control and block control groups (p = 0.59).
Spaced repetition of material through ECG quizzes improved ECG interpretation skills on an ECG post-test and mitigates the forgetting curve, maintaining student competency in ECG interpretation.
准确的心电图（ECG）解读对于患者安全至关重要，因此这一技能是医学院毕业的必要能力。根据成人学习科学，重复接触材料可以提高长期记忆保留率，这是最有证据支持的组成部分之一。这一课程创新旨在确定在主要临床学年期间通过 ECG 测验实施间隔重复和检索练习是否会提高参加纵向综合实习（LIC）的医学生的 ECG 解读技能。
课程创新应用了间隔重复和检索练习。认知科学表明，通过反复间隔接触所学材料，可以提高长期保留率。关于间隔检索的研究表明，通过涉及费力回忆的测试，可以增强记忆保留。在干预组中，LIC 学生在整个临床实习年中接受周期性 ECG 测验，以接触间隔重复效果。
对 140 名学生的 17 项后测进行了分析：LIC 干预组，N=54；块控制组，N=62；LIC 对照组，N=24。方差分析检验具有统计学意义（p<0.001）。Games-Howell 事后检验显示，LIC 干预组的平均分数明显高于 LIC 对照组（p<0.001）和块控制组（p<0.001）。LIC 对照组和块控制组之间没有显著差异（p=0.59）。
通过 ECG 测验对材料进行间隔重复提高了 ECG 后测的 ECG 解读技能，并减轻了遗忘曲线，保持了学生在 ECG 解读方面的能力。
