Repeated testing improves long‐term retention relative to repeated study: a randomised controlled trial
Abstract
Context Laboratory studies in cognitive psychology with relatively brief final recall intervals suggest that repeated retrieval in the form of tests may result in better retention of information compared with repeated study. Objectives Our study evaluates if repeated testing of material taught in a real‐life educational setting (a didactic conference for paediatric and emergency medicine residents) replicates these findings when measured at a more educationally relevant final recall interval of 6 months. Methods Residents participated in an interactive teaching session on two topics: (i) status epilepticus, and (ii) myasthenia gravis. Residents were randomised to two counter‐balanced groups which either took tests on status epilepticus and studied a review sheet on myasthenia gravis (SE‐T/MG‐S group) or took tests on myasthenia gravis and studied a review sheet on status epilepticus (MG‐T/SE‐S group). Testing and studying occurred immediately after teaching and then at two additional times at intervals of about 2 weeks. Residents received feedback after each test. Tests consisted of short‐answer questions and the review sheets consisted of information identical to that on the answer sheets for the tests. At about 6 months residents took a final test on both topics. Results Nineteen residents in the SE‐T/MG‐S group and 21 residents in the MG‐T/SE‐S group completed the study. Collapsing across groups, repeated testing produced final test scores that were an average of 13% higher than those produced by repeated study (39% versus 26%) at > 6 months after the initial teaching session (t[78] = 3.93, standard error of the difference = 0.03, P < 0.001, d = 0.91). Conclusions Repeated testing with feedback appears to result in significantly greater long‐term retention of information taught in a didactic conference than repeated, spaced study. Testing should be considered for its potential impact on learning and not only as an assessment device.
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The testing effect is readily found in elementary school children, middle school students, high school students, college classrooms, medical students, and older adults.
“This effect, though, is also readily found in elementary school children (Fazio & Marsh 2019, Karpicke et al. 2016), in middle school (Roediger et al. 2011a) and high school students ( McDermott et al. 2014a), in college classrooms (Lyle & Crawford 2011, Mayer et al. 2009), and in medical students (Larsen et al. 2009).Older adults, too, can benefit from retrieval practice (Meyer & Logan 2013, Rog”
From Practicing Retrieval Facilitates Learning (2021) · cites this paper as Larsen et al. 2009
In medical education, spaced quizzes on anatomy led to markedly better test performance compared to single assessments.
“In the context of medical education, Larsen et al. [39] found that spaced quizzes on anatomy led to markedly better test performance compared to single assessments, demonstrating the advantages of frequent retrieval practice over time.”
From Formative assessment and feedback in medical education: A practical guide: AMEE Guide No. 189 (2026) · cites this paper as [39]
Randomized controlled trials demonstrate that repeated testing promotes better retention of information than repeated studying (the testing effect).
“For example, randomized controlled trials demonstrate that repeated testing promotes better retention of information than repeated studying, a phenomenon known as the testing effect.3,4”
From Effect of repeated/spaced formative assessments on medical school final exam performance (2017) · cites this paper as [4]
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- Authors
- Larsen, D. P., Butler, A. C., & Roediger III, H. L.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Larsen, Douglas P
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 2009-11-17
- Volume
- 43
- Issue
- 12
- Pages
- 1174-1181
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- OpenAlex
- W2154424209
- Cited by
- 383
- References
- 18
- Citations by year
- 2026: 18 · 2025: 19 · 2024: 16 · 2023: 26 · 2022: 32 · 2021: 32 · 2020: 30 · 2019: 33 · 2018: 30 · 2017: 15 · 2016: 22 · 2015: 29 · 2014: 25 · 2013: 19 · 2012: 16
- FWCI
- 5.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Education (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- retesting, retrieval practice, long-term retention, feedback, medical residents, status epilepticus, myasthenia gravis
- MeSH terms
- Clinical Competence, Educational Measurement, Humans, Retention, Psychology, Teaching, Time Factors
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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