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Cited by 20Innovations in Medical EducationMemory Processes and InfluencesVisual and Cognitive Learning Processes

The effect of spaced learning on the learning outcome and retention of nurse anesthesia students: a randomized-controlled study

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Khalafi, Ali, Fallah, Zahra, Sharif-Nia, Hamid·2024·BMC Medical Education
DOI 10.1186/s12909-024-05290-9PMC PMC10958887
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Abstract

BACKGROUND: Poor learning and retention are common problems of students, which may be alleviated by optimization of widely used educational methods such as lectures. This study aimed to investigate the effect of spaced learning on the learning outcome and retention of nurse anesthesia students. METHODS: This was a randomized controlled study with a pre-and post-test design on 64 nurse anesthesia students who were divided into two groups of spaced lecture (n = 32) and conventional lecture (n = 32). The spaced lectures included three 30-minute training sessions with 10-minute intervals while the conventional sessions including 90 min of continuous training. Students' knowledge was measured using one valid and reliable questionnaire developed by the research team. All students in both groups took a pre-test, and their level of knowledge acquisition was evaluated immediately after the training. Their level of knowledge retention was tested two and four weeks after the lecture. RESULTS: There was no significant difference between the two groups regarding demographic characteristics (p > 0.05). In the pre-test, the mean score of knowledge in the intervention group was lower than that in the control group, there was no significant difference (p = 0.177). But after the intervention, the mean scores of learning outcome and retention in the intervention group were significantly higher than those in the control group (p < 0.001, eta = 0.576). Also, the results showed that learning outcome and retention across the three academic semesters in the two groups are significantly different, and students with a higher academic semester obtained a significantly higher mean score of knowledge and retention (p < 0.001, eta = 0.604). CONCLUSION: Spaced learning improves nurse anesthesia students' knowledge and retention more than conventional method. Future studies focusing on spaced learning should specifically examine the impact of duration and number of intervals, as well as the time gap between training and measurement of learning retention.

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  • The premise that a strict 24 h interval is universally fundamental should be qualified; this pattern is documented predominantly within non-declarative, procedural motor skill acquisition, whereas explicit conceptual and lexical mastery demonstrates superior consolidation via longer, expanding multi-day schedules.

    “For instance, the premise that a strict 24 h interval is universally fundamental should be qualified (Valderama & Oligo, 2021;Zhao et al., 2015); this pattern is documented predominantly within non-declarative, procedural motor skill acquisition (Khalafi et al., 2024), whereas explicit conceptual and lexical mastery demonstrates superior consolidation via longer, expanding multi-day schedules (Vag”

    From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Khalafi et al., 2024

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  • Inferential statistics, including ANOVA, t-tests, and multivariate regression, were systematically applied to establish the significance of time intervals and identify predictors of academic success.

    “Regarding data analysis and reliability, inferential statistics, including ANOVA, ttests, and multivariate regression, were systematically applied to establish the significance of time intervals and identify predictors of academic success (Burel et al., 2025;Khalafi et al., 2024;Simmons, 2012).”

    From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Khalafi et al., 2024

    The Statistical analysis section reports repeated-measures ANOVA, and the Results report significant differences between measurement rounds. The paper does not report using t-tests or multivariate regression to identify predictors of academic success. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • Randomized controlled trials were the most frequent approach used to validate the spacing effect.

    “Randomized controlled trials (RCTs) were the most frequent approach used to validate the spacing effect, as evidenced in clinical training, procedural skills, and reasoning tasks”

    From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Khalafi et al., 2024

    The Abstract Methods describes a randomized controlled study of spaced lectures for nurse anesthesia students, supporting an example in clinical education. The paper does not establish that RCTs were the most frequent approach to validating the spacing effect, or show that they were used across procedural-skills and reasoning tasks (searched for those terms and study-design frequency). (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • When review and retrieval practices are implemented using intervals ranging from minutes to months and interspersed with rest periods, the spacing effect emerges, associated with significant improvements in memory retention.

    “When these practices are implemented using intervals ranging from minutes to months and interspersed with rest periods, the spacing effect emerges, which is associated with significant improvements in memory retention (Cepeda et al., 2006;Khalafi et al., 2024;Llorens-Gámez et al., 2022).”

    From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Khalafi et al., 2024

  • In randomized controlled trials, risk of bias assessments (RoB 2) generally indicated low risk of bias in key domains such as randomization, outcome measurement, and data integrity.

    “In randomized controlled trials (RCTs), risk of bias assessments (RoB 2) generally indicated low risk of bias in key domains such as randomization, outcome measurement, and data integrity (Çiçek et al., 2025;Khalafi et al., 2024;Yan et al., 2024).”

    From Systematic Review of the Effectiveness of Neurodidactic Spaced Learning Strategies in Long-Term Memory (2026) · cites this paper as Khalafi et al., 2024

    The Method sections describe stratified randomization and questionnaire validation, but do not report a RoB 2 assessment or low-risk judgments for randomization, outcome measurement, or data integrity. Searches for RoB 2 and risk-of-bias assessment found no such passage in our copy. No page numbers were available. (LLM, conf=0.75)

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Cited by

Sorted by citations

Authors
Khalafi, A., Fallah, Z., & Sharif-Nia, H.
Affiliations
Ahvaz Jundishapur University of Medical Sciences (IR)
Corresponding author
Fallah, Zahra
ORCID
Khalafi, Ali
Venue
BMC Medical Education
Publisher
Springer Science and Business Media LLC
Published
2024-03-21
Volume
24
Issue
1
Pages
322-322
ISSN
1472-6920 (ISSN-L)
DOI
10.1186/s12909-024-05290-9
PMC
PMC10958887
OpenAlex
W4393038672
Cited by
20
References
5
Citations by year
2026: 8 · 2025: 8 · 2024: 4
FWCI
8.28
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Medical Education (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
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 › Experimental and Cognitive Psychology › Visual and Cognitive Learning Processes
Keywords
spaced learning, nurse anesthesia education, knowledge retention, learning outcomes, lecture method, nursing students, knowledge acquisition
MeSH terms
Anesthesia, Educational Measurement, Humans, Learning, Students

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