PC3105: Implementation of a Spaced Repetition Curriculum for Improved Long Term Retention of Board Relevant Didactics

Background: In accordance with the Accreditation Council of Graduate Medical Education (ACGME) didactics remain a core component of resident education. Didactics typically focus on factual or conceptual knowledge, knowledge that is often forgotten if only learned once. Spaced repetition however, is an evidence-based learning approach that improves long term retention of information. While the benefit of spaced repetition has been shown in undergraduate medical education, there is limited description of its formalized implementation in graduate medical education. We describe the use of spaced repetition with the goal of improving long term retention of board relevant material, and optimizing effectiveness of high yield didactics in a pediatrics residency program.

Methods: In our program residents have one hour of attending led didactics daily with a focus on American Board of Pediatrics content specifications. To promote spaced repetition we built a bi-weekly recap lecture into the schedule. All lecturers provide two board style questions and a summary slide of the “take home points” from their lecture to be used as the content for the recap lecture. The recap lecture is facilitated by an upper level resident with attending lecturers present. Questions are initially presented without multiple choice answers in order to promote free recall. Surveys were taken prior to the first implementation of the recap lecture as well as two and four months after implementation.

Results: In a program of 22 pediatric residents the average attendance of the morning didactics is between 10-14 residents due to rotation requirements. Pre-implementation surveys (n=11) showed only 50% of residents could recall all topics of the prior two week’s lectures. Residents felt they were most likely to remember didactic material when they had a pertinent patient or rotating on the relevant specialty service as opposed to when reviewing practice questions or interacting with attending lecturer (32% , 32%, 18% and 9% respectively). On post-implementation surveys (n=11), residents felt that recap lecture reinforced important concepts (39%), helped retain knowledge for board exams (33%), and helped retain knowledge for medical practice (33%). This survey question included the choice “this has not been helpful,” this option was never chosen.

Conclusion: Spaced repetition is gaining recognition in health professions education. We have shown that implementation of a spaced repetition curriculum for board relevant material in graduate medical education is feasible and well received. It is perceived to be helpful with reinforcing important concepts, and retention of knowledge useful for medical practice and board exams. We continue to propose that implementation of this novel curriculum has increased the value of time spent in didactics. We hope to increase the objectivity of our outcomes and will be analyzing data such as resident performance on national in-training examinations and board prep question banks.