The spacing effect: Improving electrocardiogram interpretation

Author:

Cunningham John M.1ORCID,Johnson Melissa2,Kincaid Troy3,Christensen Wendy1,Baker Jaime4,Turbyfill William5,Adams Jennifer E.1

Affiliation:

1. Department of Internal Medicine University of Colorado Anschutz Medical Campus Aurora Colorado USA

2. Department of Internal Medicine and Pediatrics University of Michigan Ann Arbor Michigan USA

3. Department of Internal Medicine and Pediatrics University of Colorado Anschutz Medical Campus Aurora Colorado USA

4. Division of Internal Medicine UCHealth Memorial Hospital Colorado Springs Colorado USA

5. Division of Internal Medicine VA Eastern Colorado Health Care System Aurora Colorado USA

Abstract

AbstractBackgroundAccurate electrocardiogram (ECG) interpretation is critical for safe patient care, making this skill a necessary competency for medical school graduation. Improved long‐term memory retention with repeated exposure to material is one of the most evidenced‐based components of adult learning science. This curricular innovation aimed to determine if implementing spaced repetition and retrieval practice using ECG quizzes during the principal clinical year would improve ECG interpretation skills among medical students enrolled in a Longitudinal Integrated Clerkship (LIC).ApproachThe curricular innovation applied the spacing effect and retrieval practice. Cognitive science demonstrates enhanced long‐term retention through repeated interval exposure to learned material. Studies of spaced retrieval indicate that memory retention is enhanced through tests involving effortful recall. LIC students in an intervention group were exposed to the spacing effect with periodic ECG quizzes throughout their clinical clerkship year.EvaluationThe results of the 17‐item post‐test for 140 students were analysed: LIC intervention, N = 54; block control, N = 62; and LIC control, N = 24. The ANOVA test was significant (p < 0.001). Games–Howell post hoc testing showed that the mean score in the LIC intervention group was significantly higher compared with the LIC control group (p < 0.001) and the block control group (p < 0.001). There was no significant difference between the LIC control and block control groups (p = 0.59).ImplicationsSpaced repetition of material through ECG quizzes improved ECG interpretation skills on an ECG post‐test and mitigates the forgetting curve, maintaining student competency in ECG interpretation.

Publisher

Wiley

Subject

Review and Exam Preparation,General Medicine

Reference20 articles.

1. Core Medicine Clerkship Curriculum Guide version 4.0. 2021. Accessed on 10.14.2022 at: CDIM Curriculum ‐ Core Medicine Clerkship Curriculum Guide ‐ page 64.

2. Competency in Electrocardiogram Interpretation Among Graduating Medical Students

3. Physician Training for Electrocardiogram Interpretation: A Systematic Review and Meta-Analysis

4. Feasibility of self-reflection as a tool to balance clinical reasoning strategies

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