Document Type: Original Article

Authors

1 Department of Otolaryngology-Head and Neck Surgery, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Department of E-Learning in Medical Education, Virtual School, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: In the test-enhanced spaced learning, educational
contents are presented in small packages of well-developed
test questions with a defined frequency to the learners. It is not
clear that applying this educational style might have a positive
impact on the summative assessment. Therefore, in this study
we assessed the effect of the test-enhanced spaced learning on
the otolaryngology board and annual examinations of residency
training.
Methods: In a quasi-experimental study with consecutive
sampling, all forty-four residents of otolaryngology in four levels
of training in 2016 at Tehran University of Medical Sciences
(TUMS) received daily-standardized multiple-choice questions
with a twice-repeated frequency of 10 days. Individual feedback
according to one’s response to each test was provided. The results
of national board and annual exam were compared with the same
results of all residents of other universities and previous year
TUMS’ residents for whom spaced learning were not applied and
they were considered as the control groups. The board exam had
two parts, multiple-choice questions, and computer-based clinical
examination. The annual exam format was multiple-choice
questions. The total score for each one was 150. Student’s t-test
and Mann-Whitney U test were used for comparative analyses.
Results: The mean of the board exam results showed statistically
significant improvement compared to other medical schools
(113.6±10.7 vs. 102.9±13.4 in multiple-choice questions,
p=0.048, 118.7±12.5 vs. 54.1±60.0 in the computer-based clinical
examination, p<0.001), while similar comparison results in the
previous year did not show any significant difference.
Conclusion: Spaced learning with testing effect may be useful in
the clinical education setting to improve the learning outcomes.

Keywords

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