The effect of testing on skills learning
Abstract
OBJECTIVES: In addition to the extrinsic effects of assessment and examinations on students' study habits, testing can have an intrinsic effect on the memory of studied material. Whether this testing effect also applies to skills learning is not known. However, this is especially interesting in view of the need to maximise learning outcomes from costly simulation-based courses. This study was conducted to determine whether testing as the final activity in a skills course increases learning outcome compared with an equal amount of time spent practising the skill. METHODS: We carried out a prospective, controlled, randomised, single-blind, post-test-only intervention study, preceded by a similar pre- and post-test pilot study in order to make a power calculation. A total of 140 medical students participating in a mandatory 4-hour in-hospital resuscitation course in the seventh semester were randomised to either the intervention or control group and were invited to participate in an assessment of learning outcome. The intervention course included 3.5 hours of instruction and training followed by 30 minutes of testing. The control course included 4 hours of instruction and training. Participant learning outcomes were assessed 2 weeks after the course in a simulated scenario using a checklist. Total assessment scores were compared between the two groups. RESULTS: Overall, 81 of the 140 students volunteered to participate. Learning outcomes were significantly higher in the intervention group (n = 41; mean score 82.8%, 95% confidence interval [CI] 79.4-86.2) compared with the control group (n = 40; mean score 73.3%, 95% CI 70.5-76.1) (P < 0.001). Effect size was 0.93. CONCLUSIONS: Testing as a final activity in a resuscitation skills course for medical students increases learning outcome compared with spending an equal amount of time practising the skills.
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Retrieval benefits have also been found with non-declarative tasks, including resuscitation skills learning and inductive learning of input-output functions.
“Retrieval benefits have also been found with non-declarative tasks, including resuscitation skills learning (Kromann et al., 2009) and inductive learning of input-output functions (Kang et al., 2011).”
From Neural Correlates of Long-Term Memory Enhancement Following Retrieval Practice (2021) · cites this paper as Kromann et al., 2009
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- Authors
- Kromann, C. B., Jensen, M. L., & Ringsted, C.
- Affiliations
- Copenhagen University Hospital (DK)
- Corresponding author
- Kromann, Charles B
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 2008-12-17
- Volume
- 43
- Issue
- 1
- Pages
- 21-27
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- OpenAlex
- W2172051681
- Cited by
- 315
- References
- 34
- Citations by year
- 2026: 10 · 2025: 5 · 2024: 9 · 2023: 10 · 2022: 22 · 2021: 16 · 2020: 22 · 2019: 33 · 2018: 29 · 2017: 17 · 2016: 20 · 2015: 24 · 2014: 25 · 2013: 13 · 2012: 20
- FWCI
- 12.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Education (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Keywords
- testing effect, skill acquisition, simulation-based training, resuscitation skills, medical students, learning outcomes, hands-on learning
- MeSH terms
- Clinical Competence, Curriculum, Educational Measurement, Humans, Learning, Pilot Projects, Prospective Studies, Resuscitation, Students, Medical, Program Evaluation, Single-Blind Method
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