Prior episodic learning and the efficacy of retrieval practice

In three experiments we investigated how the level of study-based, episodic knowledge influences the efficacy of subsequent retrieval practice (testing) as a learning event. Possibilities are that the efficacy of a test, relative to a restudy control, decreases, increases, or is independent of the degree of prior study-based learning. The degree of study-based learning was manipulated by varying the number of item repetitions in the initial study phase between one and eight. Predictions of the dual-memory model of test-enhanced learning for the case of one study-phase repetition were used as a reference. Results support the hypothesis that the advantage of testing over restudy is independent of the degree of prior episodic learning, and they suggest that educators can apply cued-recall testing with the expectation that its efficacy is similar across varying levels of prior content learning. Implications for testing effect theory are discussed.

Pan and Sana (2021) Pretesting vs. posttesting: Errorful generation, prequestions, and retrieval practice

The use of practice tests to enhance learning, or test-enhanced learning, ranks among the most effective of all pedagogical techniques. We investigated the relative efficacy of pretesting (i.e., errorful generation) and posttesting (i.e., retrieval practice), two of the most prominent practice test types in the literature to date. Pretesting involves taking tests before to-be-learned information is studied, whereas posttesting involves taking tests after information is studied. In five experiments (combined n = 1,573), participants studied expository text passages, each paired with a pretest or a posttest. The tests involved multiple-choice (Experiments 1-5) or cued recall format (Experiments 2-4) and were administered with or without correct answer feedback (Experiments 3-4). On a criterial test administered 5 minutes or 48 hours later, both test types enhanced memory relative to a no-test control, but pretesting yielded higher overall scores. That advantage held across test formats, in the presence or absence of feedback, at different retention intervals, and appeared to stem from enhanced processing of text passage content (Experiment 5). Thus, although the benefits of posttesting are more well-established in the literature, pretesting is highly competitive with posttesting and can yield similar, if not greater, pedagogical benefits. These findings have important implications for the incorporation of practice tests in education and training contexts.

Test-Enhanced Learning and Incentives in Biology Education

This study examined the testing effect in a postsecondary biology course with low- and high-incentive treatments and measured student learning. Although exposure to exams predicted better learning, incentive level did not moderate this effect, an outcome that contradicted recent laboratory findings that higher incentives decreased the testing effect.

Beyond right or wrong: More effective feedback for formative multiple-choice tests

Introduction The role of feedback in test-enhanced learning is an understudied area that has the potential to improve student learning. This study investigates the influence of different forms of post-test feedback on retention and transfer of biomedical knowledge within a test-enhanced learning framework. Methods 64 participants from a Canadian and an Australian medical school sat two single-best-answer formative multiple choice tests one week apart. We compared the effects of conceptually focused, response-oriented, and simple right/wrong feedback on a learner’s ability to correctly answer new (transfer) questions. On the first test occasion, participants received parent items with feedback, and then attempted items closely related (near transfer) to and more distant (far transfer) from parent items. In a repeat test at 1 week, participants were given different near and far transfer versions of parent items. Feedback type, and near and far transfer items were randomized within and across participants. Results Analysis demonstrated that response-oriented and conceptually focused feedback were superior to traditional right/wrong feedback for both types of transfer tasks and in both immediate and final retention test performance. However, there was no statistically significant difference between response-orientated and conceptually focused groups on near or far transfer problems, nor any differences in performance between our initial test occasion and the retention test 1 week later. As with most studies of transfer, participants’ far transfer scores were lower than for near transfer. Discussion Right/wrong feedback appears to have limited potential to augment test-enhanced learning. Our work suggests that item-level feedback and feedback that identifies and elaborates on key conceptual knowledge are two important areas for future research on learning, retention and transfer.

2530. TACO Tuesday as a Medical Education Tool

Background Novel strategies in medical education including the flipped classroom, test-enhanced learning, and gaming have proven to be effective for preclinical learners but little is known about their efficacy in post-graduate education. We implemented an educational tool in our Infectious Diseases (ID) Fellowship Training program called TACO (To Assess Cognitive Operations) Tuesday that utilizes aspects of the flipped classroom, test-enhanced learning, and gaming to improve ID fellow engagement, satisfaction, knowledge retention, and board examination preparation in association with a weekly ID core didactic curriculum. Methods One to three multiple choice clinical vignettes were emailed to ID fellows the day prior to their weekly didactic lecture. The first fellow to answer all questions correctly was the winner for the week. The correct answer choices along with detailed rationales were distributed to all fellows at the end of the week. After one year of using this educational tool, we surveyed fellows to evaluate its impact on their engagement with the weekly didactic sessions, self-perception of content retention, and sense of preparation for the ID board examination. Results We had a response rate of 82% with 9 of 11 fellows polled participating. Of those, two-thirds attempted to answer the multiple-choice questions prior to lecture and most (77%) reviewed the correct answer choices and rationales weekly. All participants felt the educational tool helped improve their engagement with the lectures and half felt it increased overall satisfaction with their educational experience. The majority felt the tool increased content retention and their level of preparation for the ID board examination. Implementation of this tool was associated with a higher mean IDSA in-training examination score compared with scores from the previous year (518 vs 469). Conclusion ID fellows found that an educational tool utilizing a flipped classroom, test-enhanced learning, and gaming in association with a weekly core didactic curriculum increased their engagement, satisfaction, knowledge retention, and board examination preparation. Future studies will investigate the impact of this tool on knowledge retention and ID board examination scores within our institution as well as across institutions. Disclosures All authors: No reported disclosures.

Impact of instructor professional background and interim retesting on knowledge and self-confidence of schoolchildren after basic life support training: a cluster randomised longitudinal study

IntroductionTo increase the rate of bystander resuscitation, basic life support (BLS) training for schoolchildren is now recommended on a broad level. However, debate continues about the optimal teaching methods. In this study, we investigated the effects of a 90 min BLS training on female pupils’ BLS knowledge and self-confidence and whether learning outcomes were influenced by the instructors’ professional backgrounds or test-enhanced learning.MethodsWe conducted a cluster randomised, longitudinal trial in a girls’ grammar school in Germany from 2013 to 2014. Pupils aged 10–17 years were randomised to receive BLS training conducted by either emergency physicians or medical students. Using a multiple-choice questionnaire and a Likert-type scale, BLS knowledge and self-confidence were investigated before training (t0), 1 week (t1) and 9 months after training (t2). To investigate whether test-enhanced learning influenced learning outcomes, the questionnaire was administered 6 months after the training in half of the classrooms. The data were analysed using linear mixed-effects models.ResultsThe study included 460 schoolchildren. BLS knowledge (mean number of correct answers) increased from 5.86 at t0to 9.24 at t1(p<0.001) and self-confidence (mean score on the Likert-type scale) increased from 8.70 at t0to 11.29 at t1(p<0.001). After 9 months, knowledge retention was good (8.94 at t2; p=0.080 vs t1), but self-confidence significantly declined from t1to 9.73 at t2(p<0.001). Pupils trained by medical students showed a slight but statistically significant greater increase in the knowledge at both t1and t2, whereas instructors’ background did not influence gain or retention of self-confidence. Retesting resulted in a marginally, non-significantly better retention of knowledge.ConclusionsBLS training led to short-term gains in knowledge and self-confidence. Although knowledge was retained at 9 months after the training session, self-confidence significantly decreased. Interim testing did not appear to impact retention of knowledge or self-confidence. Medical students should be considered as instructors for these courses given their favourable learning outcomes and greater availability.