Randomised retrieval practice in medical education

Randomised retrieval practice is an effective educational process ​

Randomised retrieval practice is an educational process that has been shown to be more effective than other practice and study strategies for developing students' abilities to recall previously learned concepts and perceive their relevance to the immediate situation. 

The underlying principle of retrieval practice is that spaced recall or repeated practice in recalling information yields greater long-term memory retention gains compared to repeated study over similar time intervals (Lee, 2016, p. 719)

In medicine randomised retrieval practice can help develop clinical reasoning by causing students to recall previously learned concepts and apply them in a new situation, e.g., a case in a clinical setting. This keeps the previously learned material "fresh", and the requirement to recall the information enhances future retrievability, and the application of the previously learned material to a new case in a new setting enhances the generalisability of the information, and the detection of core elements of concepts through the principle of variation in the settings or cases of application.

Why use Randomised retrieval practice?​

According to McSparron (2019, p. 96) periodic re-learning of material prevents memory decay.

• Aids long-term retention
• Aids perception of relevance by using clinical or other settings as triggers to generate opportunities for retrieval of relevant conceptual / theoretical information;
• Aids in the refinement of understanding of concepts by their application at different times to different cases that may differ from each other in informative ways.

Quick guide ​

1. choose the conceptual knowledge to be developed;
2. create a variety of circumstances in which retrieval is required of the students;
3. randomise the occurrence of these circumstances.
4. use questions in the clinical setting, to revisit key learnings (McSparron et al., 2019, p. 97);
5. Have learners identify the key points from a clinical or tutorial session (McSparron et al., 2019, p. 97);
6. Revisit key learnings during subsequent clinical rounds (McSparron et al., 2019, p. 97).

Personal practice check ​

• Do I know what the concept or knowledge is that I want to develop?
• Have I created a selection of settings and cases to which students will be required to apply the concept or knowledge?
• Have I spaced and distributed the deployment of retrieval practice opportunities so that these seem random, from the students' perspective?
• Have I exploited subtle differences between clinical cases to cause a deeper or more nuanced understanding of concepts as they are applied to varying types of case?

Further reading ​

Lee, M. W. (2016). Using Retrieval Practice to Teach Professionalism to Medical Students: A Proposal. Medical Science Educator, 26(4), 719–722. https://doi.org/10.1007/s40670-016-0304-1

McSparron, J. I., Vanka, A., & Smith, C. C. (2019). Cognitive learning theory for clinical teaching. Clinical Teacher, 16(2), 96–100. https://doi.org/10.1111/tct.12781

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Download the quick guide here:  (Click me) ​ 

References

Lee, M. W. (2016). Using Retrieval Practice to Teach Professionalism to Medical Students: A Proposal. Medical Science Educator, 26(4), 719–722. https://doi.org/10.1007/s40670-016-0304-1

McSparron, J. I., Vanka, A., & Smith, C. C. (2019). Cognitive learning theory for clinical teaching. Clinical Teacher, 16(2), 96–100. https://doi.org/10.1111/tct.12781