Feedback at Test Can Reverse the Retrieval-Effort Effect

Systematic review of distributed practice and retrieval practice in health professions education

To determine the effect of distributed practice (spacing out of study over time) and retrieval practice (recalling information from memory) on academic grades in health professions education and to summarise a range of interventional variables that may affect study outcomes. A systematic search of seven databases in November 2022 which were screened according to predefined inclusion criteria. The Medical Education Research Study Quality Instrument (MERSQI) and Newcastle-Ottawa Scale-Education (NOS-E) were used to critically appraise eligible articles. A summary of interventional variables includes article content type, strategy type, assessment type and delay and statistical significance. Of 1818 records retrieved, 56 were eligible for inclusion and included a total of 63 experiments. Of these studies, 43 demonstrated significant benefits of distributed practice and/or retrieval practice over control and comparison groups. Included studies averaged 12.23 out of 18 on the MERSQI and averaged 4.55 out of 6 on the NOS-E. Study designs were heterogeneous with a variety of interventions, comparison groups and assessment types. Distributed practice and retrieval practice are effective at improving academic grades in health professions education. Future study quality can be improved by validating the assessment instruments, to demonstrate the reliability of outcome measures. Increasing the number of institutions included in future studies may improve the diversity of represented study participants and may enhance study quality. Future studies should consider measuring and reporting time on task which may clarify the effectiveness of distributed practice and retrieval practice. The stakes of the assessments, which may affect student motivation and therefore outcomes, should also be considered.

The Forward Effect of Delayed Judgments of Learning Is Influenced by Difficulty in Memory and Category Learning

Delayed judgment of learning (JOL) is a widely used metacognitive monitoring strategy that can also enhance learning outcomes. However, the potential benefits of delayed JOL on subsequent learning of new material, known as the forward effect of delayed JOL, and its stability and underlying mechanisms have yet to be fully explored. In this study, we investigated the forward effect of delayed JOL using previously unexamined word pair materials and explored the boundary conditions of this effect by manipulating the difficulty of the materials. We also examined this effect within the context of category learning. Our findings demonstrate that delayed JOL significantly enhanced the retention of new information (Experiment 1A), while the forward effect of the delayed JOL occurred only for material with a certain degree of difficulty rather than for easy material (Experiment 1B). These findings were extended and replicated using category learning (Experiment 2). These results suggest that delayed JOL can be used as a preparation strategy for subsequent learning, particularly when faced with challenging materials. Our study provides novel insights into the potential benefits and limitations of delayed JOL and contributes to our understanding of the underlying mechanisms that govern metacognitive monitoring and learning strategies.

Reversing the testing effect by feedback is a matter of performance criterion at practice

Retrieval practice is generally considered to be one of the most effective long-term learning strategies and is presumed to be more favorable than repeated study. However, a few recent studies have demonstrated that repetitive feedback at final recall can reverse the long-term advantage of testing over restudy. The result that feedback at long-term tests can dramatically decrease the relative effectiveness of retrieval-based learning could be important for both theoretical and practical reasons. Considering that these earlier studies administered low retrieval success at retrieval practice, we investigated whether the effect of feedback on the testing effect is modulated by the level of retrieval success during practice. In three experiments the level of success at retrieval practice was manipulated by multiple pre-practice learning trials, and multiple tests with feedback were applied after a 1-week retention interval at final recall. Our results have demonstrated that a feedback-induced reversed testing effect was present only at low retrieval success during practice (Experiment 1), whereas with moderate (Experiment 2) and high retrieval success (Experiment 3) during practice a significant testing effect emerged and no reversed testing effect was found even after repeated cycles of feedback. These results point to the conclusion that the level of retrieval success was the key factor in reversing the testing effect in earlier studies. Application of high retrieval success during practice can produce long-lasting accessible memories even in learning settings applying multiple tests with feedback.