Active Retrieval Improves Procedural Learning in Orthopedic Surgery.

Area of Science:

• Medical Education
• Surgical Skills Training
• Cognitive Psychology

Background:

• The testing effect, or enhanced learning through retrieval, is well-documented but primarily studied with simple materials.
• Its efficacy in complex procedural learning, such as surgical techniques, remains less understood.
• Active retrieval, involving effortful recall, contrasts with passive studying, which relies on recognition.

Purpose of the Study:

• To investigate whether active retrieval testing improves procedural learning of fracture fixation compared to passive studying.
• To assess the impact of different learning strategies on the retention of surgical procedures.

Main Methods:

• Fifty participants learned a fracture fixation procedure via video and a guided pretest.
• Participants were randomized to either passive studying (reading) or active retrieval (writing steps from memory).
• Performance was assessed via Objective Structured Assessment of Technical Skill (OSATS) immediately and after a 1-week retention interval.

Main Results:

• The passive studying group initially scored higher on the OSATS, particularly in recalling the correct procedural steps.
• However, the active retrieval group demonstrated significantly less forgetting at the retention test.
• Active retrieval through writing led to better long-term retention of fracture fixation knowledge.

Conclusions:

• Testing via active retrieval (writing) enhances long-term retention of complex procedural knowledge in fracture fixation.
• This finding supports the integration of active retrieval methods into surgical education curricula.
• Further research should explore other active retrieval techniques, like verbal recall, in surgical practice.