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Updated: Feb 15, 2026

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Augmenting Fellow Education Through Spaced Multiple-Choice Questions.

Alice E Barsoumian1, Heather C Yun1

  • 1Infectious Disease Service, Department of Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, San Antonio TX 78234.

Military Medicine
|February 6, 2018
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Summary

Implementing spaced education improved infectious disease fellow training, enhancing knowledge retention and learner satisfaction. This method effectively addresses knowledge gaps, particularly in operational medicine.

Keywords:
FellowshipMilitary uniqueSpaced educationurriculum

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Area of Science:

  • Medical Education
  • Infectious Diseases
  • Continuing Medical Education

Background:

  • The San Antonio Uniformed Services Health Education Consortium Infectious Disease Fellowship historically used monthly quizzes to assess knowledge.
  • Faculty noted increasing dissatisfaction with the traditional quiz format.
  • Spaced education, known for improving knowledge retention, had not been described in infectious disease fellowship training.

Purpose of the Study:

  • To assess the introduction of a spaced education curriculum to improve the fellowship quiz experience.
  • To evaluate its impact on knowledge retention and learner satisfaction.

Main Methods:

  • A pre-intervention survey assessed the traditional quiz.
  • A spaced education curriculum using the Qstream platform was implemented, delivering questions every 2 days.
  • Fellow satisfaction was assessed via surveys and semi-annual reviews over 5 years.

Main Results:

  • Pre-intervention, fellows were dissatisfied with the time commitment of monthly quizzes but satisfied with knowledge retention.
  • Post-intervention, fellows reported high satisfaction with the spaced education platform, finding it enjoyable and beneficial for board preparation.
  • The correct answer rate improved significantly, and time commitment decreased substantially (mean 47 min/month).

Conclusions:

  • Spaced education significantly improved the learner experience and demonstrated material mastery in infectious disease fellows.
  • It is a viable method to augment training, especially for operational medicine and curricular gaps.
  • Data generated can support objective knowledge assessment for accreditation requirements.