Spacing for Professional Learning
[Cover image by ovariancancer1 on Pixabay]
by Cindy Nebel
Naturally, we typically talk about classroom learning with student learners. But fundamentally, we are all learners and as professionals in education, we are expected to continue learning. This means that the same evidence-based strategies that you seek out for your students can apply to you as well.
Today I’m reviewing a recent paper that used spaced repetition (and retrieval) to help practicing physicians retain information that they would need to renew their licenses (1). This required both retention of information but also the ability of these physicians to transfer their knowledge to clinical scenarios. We’ve talked before about how difficult transfer of knowledge can be, so this was an ambitious task.
For this study, the researchers used an existing platform that gives physicians practice questions. Because the platform is entirely formative in nature, the physicians can take their time going through the questions and they get excellent feedback explaining why each answer is correct. The physicians also got continuing education credits for engaging with the platform. Because this was a national study using a pre-existing platform, the researchers started the study with over 26,000 participants! Almost 17,000 participants stayed on until the end!
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At the beginning of the study, the researchers selected six questions that participants would see repeated once or twice during the next year. The questions they chose were individualized – those questions that participants had gotten wrong before but with high confidence were chosen first. In other words, much of this study was about correcting misconceptions.
At the end of the study, participants received those same questions again, but also six questions that were rewritten to use the same concept, but with a new clinical scenario (e.g. different patient age, symptoms, or treatment). Unsurprisingly, spaced repetition led to higher scores on the repeated questions (58% vs. 43%), with two repetitions being better than one (62% vs. 52%). This difference was also true on the transfer questions with the single repetition (56%) scoring higher than no repetition (52%) and two repetitions (60%) being better than one.
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A lot of times these spaced retrieval studies give me pause. What are the chances that our students are going to see the exact same question later on? And is it really surprising that they would perform better having seen that question repeatedly? This study feels different to me for a number of reasons. The space between repetitions is long here. Physicians saw the same question, but many months apart. They were far less likely to remember that specific question. Second, it is possible that physicians will see the same presentation of disease over the course of their career. How many times will one physician see a patient with the flu? Getting better at diagnosing flu repeatedly has a lot of clinical relevance. And the fact that the transfer questions were similar feels like the right thing to do here too. Physicians are likely to see flu in a number of different types of patients with somewhat varying presentations and histories. Knowing that spaced repetition helps them do that more effectively certainly gives me some amount of peace of mind!
What does this mean for you? If you are a classroom educator, as the majority of our readers are, then I want you to consider how this might match up with your professional learning. This might mean that, after you go to that PD session next week, you create for yourself some delay delivery emails that ask you to answer classroom scenario questions about what you learned. If you’re designing PD, this is a great way of making sure that session isn’t just “one and done” but instead gives participants the opportunity to apply what they’ve learned directly to the classroom. But the key is that you want these things to repeat over the course of months. Bring them up again. Talk about different contexts.
The bottom line is this: we can do a better job of practicing what we preach. Spaced retrieval practice isn’t just for the students; it can help us to be better educators too.
Reference:
(1) Price, D. W., Wang, T., O’Neill, T. R., Morgan, Z. J., Chodavarapu, P., Bazemore, A., ... & Newton, W. P. (2025). The effect of spaced repetition on learning and knowledge transfer in a large cohort of practicing physicians. Academic Medicine, 100(1), 94-102.
