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Cited by 41Innovations in Medical EducationMemory Processes and InfluencesSecond Language Acquisition and Learning

Characterization of medical students recall of factual knowledge using learning objects and repeated testing in a novel e-learning system

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Taveira-Gomes, Tiago, Prado-Costa, Rui, Severo, Milton, Ferreira, Maria Amélia·2015·BMC Medical Education
DOI 10.1186/s12909-014-0275-0PMC PMC4326410
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Abstract

BACKGROUND: Spaced-repetition and test-enhanced learning are two methodologies that boost knowledge retention. ALERT STUDENT is a platform that allows creation and distribution of Learning Objects named flashcards, and provides insight into student judgments-of-learning through a metric called 'recall accuracy'. This study aims to understand how the spaced-repetition and test-enhanced learning features provided by the platform affect recall accuracy, and to characterize the effect that students, flashcards and repetitions exert on this measurement. METHODS: Three spaced laboratory sessions (s0, s1 and s2), were conducted with n=96 medical students. The intervention employed a study task, and a quiz task that consisted in mentally answering open-ended questions about each flashcard and grading recall accuracy. Students were randomized into study-quiz and quiz groups. On s0 both groups performed the quiz task. On s1 and s2, the study-quiz group performed the study task followed by the quiz task, whereas the quiz group only performed the quiz task. We measured differences in recall accuracy between groups/sessions, its variance components, and the G-coefficients for the flashcard component. RESULTS: At s0 there were no differences in recall accuracy between groups. The experiment group achieved a significant increase in recall accuracy that was superior to the quiz group in s1 and s2. In the study-quiz group, increases in recall accuracy were mainly due to the session, followed by flashcard factors and student factors. In the quiz group, increases in recall accuracy were mainly accounted by flashcard factors, followed by student and session factors. The flashcard G-coefficient indicated an agreement on recall accuracy of 91% in the quiz group, and of 47% in the study-quiz group. CONCLUSIONS: Recall accuracy is an easily collectible measurement that increases the educational value of Learning Objects and open-ended questions. This metric seems to vary in a way consistent with knowledge retention, but further investigation is necessary to ascertain the nature of such relationship. Recall accuracy has educational implications to students and educators, and may contribute to deliver tailored learning experiences, assess the effectiveness of instruction, and facilitate research comparing blended-learning interventions.

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  • Non-randomized interventions, assessed using ROBINS-I, showed moderate to low risks, particularly regarding participant selection and confounding variables.

    “Non-randomized interventions, assessed using ROBINS-I, showed moderate to low risks, particularly regarding participant selection and confounding variables (Lyle et al., 2020;Taveira-Gomes et al., 2015).”

    From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Taveira-Gomes et al., 2015

    The Methods, Intervention design section says students were assigned to the study-quiz or quiz group using simple randomization, contrary to describing this study as a non-randomized intervention. The paper does not report a ROBINS-I assessment or moderate-to-low risk ratings for participant selection and confounding. (LLM, conf=0.88)

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  • In studies such as Lyle et al. (2020) and Taveira-Gomes et al. (2015), the lack of formal randomization introduced potential confounding variables-such as prior knowledge or varying levels of baseline cognitive load-which may have interacted with the spacing effect.

    “In studies such as those of Lyle et al. (2020) and Taveira-Gomes et al. (2015), the lack of formal randomization introduced potential confounding variables-such as prior knowledge or varying levels of baseline cognitive load-which may have interacted with the spacing effect.”

    From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Taveira-Gomes et al., 2015

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3 of the 85 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. [55]Martinez M. Designing learning objects to personalize learning. PhD thesis. Bloomington IL; 2002.
  2. [80]Martinez M. Designing learning objects to mass customize and personalize learning. In: The instructional use of learning objects agency for instructional technology and the association for educational communications and technology. Wiley D, editor. 2001. Retrieved 6th Apr 2014, from http://www.reusability.org/read/chapters/martinez.doc.

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Authors
Taveira-Gomes, T., Prado-Costa, R., Severo, M., & Ferreira, M. A.
Affiliations
Universidade do Porto (PT)
ORCID
Ferreira, Maria Amélia
Venue
BMC Medical Education
Publisher
Springer Science and Business Media LLC
Published
2015-01-24
Volume
15
Issue
1
Pages
4-4
ISSN
1472-6920 (ISSN-L)
DOI
10.1186/s12909-014-0275-0
PMC
PMC4326410
OpenAlex
W1996637844
Cited by
39
References
85
Citations by year
2026: 6 · 2025: 6 · 2024: 1 · 2023: 4 · 2022: 5 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 4
FWCI
3.22
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Medical Education (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Memory Processes and Influences
  • Social Sciences › Psychology › Developmental and Educational Psychology › Second Language Acquisition and Learning
Keywords
spaced repetition, retrieval practice, recall accuracy, learning objects, flashcards, online learning, medical students, knowledge retention, open-ended questions, judgments of learning, variance components
MeSH terms
Adolescent, Adult, Computer-Assisted Instruction, Curriculum, Education, Medical, Educational Measurement, Female, Golgi Apparatus, Humans, Male, Pilot Projects, Portugal, Practice, Psychological, Retention, Psychology, Software, Young Adult

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