Use of unannounced spaced telephone testing to improve retention of knowledge after life-support courses.

BACKGROUND: Life-support courses improve knowledge and skills but attrition of factual knowledge is considerable. There is evidence that retention can be improved by spaced testing. AIM: To investigate the effect of spaced testing on retention of knowledge after a life-support course. METHOD: In a prospective-controlled trial using stratified randomization, 19 final-year medical students followed a half-day life-support course involving an identical written pre-test and end-of-course test consisting of a factual and a clinical case-based test (CCT). They were subsequently assigned to an intervention and a control group matched for the end-of-course test scores. The intervention group was given four unannounced spaced CCTs intermediate tests over 2 months. The control group took one intermediate test at 6 weeks. All students took a final retention test identical to the pre-test at 2 months. RESULTS: Test performance improved equally in both groups immediately after the course. Students in the intervention group retained factual information significantly better than those in the control group. There was no difference in performance on the CCTs. CONCLUSION: Unannounced spaced testing seems to have a positive effect on retention of factual knowledge after life-support courses. There was no evidence of an effect on clinical problem-solving ability.

Early clerkships.

BACKGROUND: Early clinical experience is being introduced in innovative, vertically integrated undergraduate medical curricula. While in many cases, this early clinical experience is limited to the presence of patients during lectures, in Utrecht students gain 'hands on' experience of daily clinical practice during 6-week clerkships. We studied students' and teachers' opinions of these full clerkships in the third year of a medical course. METHODS: All 238 clinical teachers and 89 students involved in the 2003/2004 third year clerkships of the new Utrecht medical curriculum were asked to fill in a 16-item questionnaire about background knowledge, clinical skills, communication skills, and readiness for clerkships. Answers were given on a 5-point Likert scale. Response was 61%. RESULTS: Both students and clinical teachers answered all statements positively (score > 3.00), although some statements were awarded higher scores by students than teachers. In conclusion, students and teachers appear to appreciate clerkships early in the curriculum. CONCLUSIONS: Less background knowledge and a lower age than is usual for the more traditional (later) clerkships do not appear to hinder successful completion of an early clerkship. Indeed, early clerkships have several advantages, such as early observation of the future profession, increased motivation for further study, contextual learning, and improvement of clinical skills.