Adaptive spaced education improves learning efficiency: A randomized controlled trial
Abstract
PURPOSE: Spaced education is a novel form of online education that harnesses the 2 psychology research findings of spacing and testing effects. Spaced education is delivered by daily emails containing clinically relevant multiple choice questions. To take advantage of the spacing effect the questions are repeated at fixed intervals for a fixed number of repetitions. An adaptive spaced education system was developed to customize spacing intervals and the number of repetitions based on learner knowledge level. To determine whether this system improves learning efficiency I performed a randomized trial to compare the learning efficiency of adaptive vs nonadaptive spaced education systems among surgery students at 2 medical schools. MATERIALS AND METHODS: A total of 62 year 3 students were randomized to identical course content in adaptive or nonadaptive spaced education formats. The course consisted of 40 validated, spaced education items on the 4 urology topics benign prostatic hyperplasia, erectile dysfunction, prostate cancer and prostate specific antigen screening. The nonadaptive cohort received daily emails containing 2 questions with a linear review of the material 20 days after initial presentation. The adaptive cohort received daily emails via an adaptive algorithm that limited the repetition of mastered content. Each cohort completed a validated end of course test. RESULTS: The adaptive cohort answered significantly fewer spaced education items than the nonadaptive cohort (p = 0.001) but achieved comparable end of course test scores (p = 0.37). The adaptive algorithm increased learning efficiency by 38%. CONCLUSIONS: Adaptive spaced education boosts learning efficiency.
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Adaptive space education, which adjusts spacing intervals and repetitions according to the learner's knowledge level, improves long-term retention.
“Adaptive space education, which adjusts spacing intervals and repetitions of learning material according to the learner's knowledge level, has been shown to improve long-term retention [158].”
From Leveraging AI in E-Learning: Personalized Learning and Adaptive Assessment through Cognitive Neuropsychology—A Systematic Analysis (2024) · cites this paper as [158]
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“Adaptive space education systems, providing optimization of spacing intervals and repetitions, improve the efficiency of learning and retention [158].”
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- Authors
- Kerfoot, B. P.
- Affiliations
- Harvard University (US)
- Corresponding author
- Kerfoot, B. Price
- ORCID
- Kerfoot, B. Price
- Venue
- Journal of Urology
- Published
- 2010-02
- Volume
- 183
- Issue
- 2
- Pages
- 678-681
- ISSN
- 0022-5347 (ISSN-L)
- 1527-3792
- OpenAlex
- W2138404325
- Cited by
- 81
- References
- 15
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 9 · 2020: 9 · 2019: 5 · 2018: 6 · 2017: 7 · 2016: 3 · 2015: 3 · 2014: 8 · 2013: 4 · 2012: 5
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Urology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Physical Sciences › Computer Science › Artificial Intelligence › Intelligent Tutoring Systems and Adaptive Learning
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- adaptive learning, spacing effect, testing effect, online medical education, urology education, learning efficiency, prostate cancer, benign prostatic hyperplasia, erectile dysfunction, PSA screening
- MeSH terms
- Clinical Clerkship, Education, Medical, Female, Humans, Male, General Surgery
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