Retrieval Practice in the Health Professions
Cover image by u_9p7tw4noz0 from Pixabay
By Althea Need Kaminske
Note: The following describes Health Professions Education within the U.S.
As a learning scientist interested in how learning works, health professions education is an exciting and dynamic environment to explore best practices in the application of the principles and strategies that we study in cognitive psychology. Recently, Cindy and I published a paper entitled, “The Use of Retrieval Practice in the Health Professions: A State-of-the-Art Review” along with two other cognitive psychologists who work as Medical Education Learning Specialists (MELS), Michael J. Serra and Kristen M. Coppola (1). In this post I want to summarize two sections from the paper - why health professions have embraced retrieval practice and barriers and challenges to effective use of retrieval practice in health professions.
Why Have the Health Professions Embraced Retrieval Practice?
One thing that surprised me when I started my role as a MELS was that I didn’t really have to sell people on using retrieval practice. Students assured me that they knew the value of practice and recall; and my M.D. colleagues were somewhat well read on the topic, many having read books like Make it Stick (2) or about retrieval practice within medical education journals. In the our recent paper we wanted to explore why that was and we settled on four reasons.
First, the fast pace and high volume of content in the health professions, combined with high-stakes licensing exams (particularly within medical education), necessitates the use of highly effective strategies. Retrieval practice yields such obvious benefit to learning and retention that it makes sense that health professions would find it incredibly useful.
Second, health professions students are highly motivated to find ways to make their studying as efficient as possible. The amount of basic science information that a health professions student has to know is only ever increasing, but the length of time they have in training remains the same. At the same time there is immense pressure to perform well on licensing exams. Poor performance can lead to costly delays, no small amount of stigma, and even dismissal from a program. An entire market for third party resources to help optimize studying and prepare for tests has developed in response. Among medical students flashcard programs like Anki, question banks like UWorld, Amboss, or TrueLearn, and video explainers like Sketchy are popular. All of these programs rely on retrieval practice, spaced practice, and, in the case of Sketchy, imagery, to improve learning. Anki, in particular, uses a spaced repetition algorithms (currently SuperMemo2 and FSRS) to determine when you should practice retrieval with material to optimize retention based on past performance. So, when I say that medical students are motivated to make studying as efficient as possible, I mean that they are willing to pay hundreds of dollars for access to additional resources for retrieval practice or to learn how to navigate open-source software.
Third, somewhat paradoxically, despite the high admission standards for health professions programs, a large portion of students lack strong study skills and habits. A recent study of medical students found that half fell below average on measures of self-regulated learning (3). In my experience those who lack strong study skills have either brute-forced their way through ineffective study habits or had enough background knowledge or experience that they were not sufficiently challenged until medical school. This combined with the fast pace and high volume of information within health professions education, perhaps explains why health professions are so highly motivated to seek out retrieval practice.
Finally, and perhaps most compelling (at least for me), is the simple fact that retrieval practice is a very easy strategy to use. It is one of many tools that any student needs to be successful, but it’s also a pretty versatile tool. It improves comprehension, long-term memory, and provides real-time, objective feedback on performance. While students may come into health professions with a range of ability in self-regulated learning (see above), effective use of retrieval practice can be a valuable component of the development of self-regulated learning.
Barriers or Challenges to Effective Use of Retrieval Practice in the Health Professions
Despite the advantages of retrieval practice, particularly within the health professions as outlined above, students may still be hesitant to engage in retrieval practice. One simple reason is that while retrieval practice is more well-known among researchers and educators, students may not always be aware of it, though a recent study by Witherby et al. (2025) showed that undergraduate psychology students rated retrieval practice as the most effective strategy so there’s evidence this may be changing (4).
Additionally, while students may be aware of retrieval practice in broad terms, they may have limited knowledge about how to best use retrieval practice or any of the nuances of the application of retrieval practice. For example, Sheehy et al. (2024) found that students may choose to look up the answer when they are unsure (rather than trying to retrieve it from memory) or only choose to use retrieval practice for items they missed in practice (5). Both of these strategies indicate that students are unaware of best practices around retrieval practice and may be experiencing limited benefits of retrieval practice.
This lack of understanding about the nuances of retrieval practice could lead to misleading experiences of retrieval practice. Students may rely on forms of retrieval practice that are not appropriate for their learning goal and therefore assume that a lack of progress towards those goals is due to the retrieval practice. For example, students heavily use flashcard software like Anki to prepare for exams. This use of flashcards is highly effective when exams focus on low-level facts, but may not yield the level of comprehension necessary for exams that focus on higher order inferences. Instead, retrieval practice using question banks that more closely align with the types of questions posed on the exam would likely be more beneficial for improving exam performance.
A final challenge to students using retrieval practice is negative beliefs about testing and errors. It is worth noting that many medical students experience academic shame around poor performance, leading to reduced help-seeking behavior (6). Students may be hesitant to use retrieval practice because they worry that errors signal that they not only don’t know the material, but perhaps are unfit for their program (feelings that can be related to imposter syndrome).
By and large health professions education have embraced retrieval practice. In many ways health professions are ideally suited for fast adoption of retrieval practice as it helps to optimize learning under the rather stringent conditions of health professions education. While the health professions make frequent use of retrieval practice there is still work to be done to address the barriers and challenges to effective and efficient use of this learning strategy.
References
Serra, M. J., Kaminske, A. N., Nebel, C., Coppola, K. M. (2025). The Use of Retrieval Practice in the Health Professions: A State-of-the-Art Review. Behavioral Sciences, 15(7), 974. https://doi.org/10.3390/bs15070974
Brown, P. C., Roediger, H. L. III, & McDaniel, M. A. (2014). Make it stick: The science of successful learning. The Belknap Press of Harvard University Press.
O’Sullivan, S., Hageh, C. A., Dimassi, Z., Alsoud, L. O., Presley, D., & Ibrahim, H. (2024). Exploring challenges in learning and study skills among first-year medical students: A case study. BMC Medical Education, 24, 869. https://doi.org/10.1186/s12909-024-05850-z
Witherby, A. E., Babineau, A. L., & Tauber, S. K. (2025). Students’, Teachers’, and Parents’ Knowledge About and Perceptions of Learning Strategies. Behavioral Sciences, 15, 160. https://doi.org/10.3390/bs15020160
Sheehy, R., Scott, D., Davis, D., Roffler, M., Sweatman, T., & Nemec, E. (2024). Medical student use of practice questions in their studies: A qualitative study. BMC Medical Education, 24, 1181. https://doi.org/10.1186/s12909-024-06168-6
Coudret, D. J. (2020). Turning the spotlight on shame: Fostering adaptive responses to feelings of academic shame in medical students [Doctoral dissertation, Arizona State University].
