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Cumulative Cognition: Strengthening Learning with Progressive Content Delivery.
Carley Yawn1, Logan Van Ravenswaay1, Krista Marcello1
1Clinical Education Alliance, Reston, VA, USA.
Journal of CME
|July 22, 2025
Summary
Spaced repetition and prior exposure to material significantly improve healthcare professionals' knowledge retention in continuing professional development (CPD) programs. Repeated learning engagements are key for sustained clinical competence.
Area of Science:
- Cognitive Psychology
- Medical Education
- Health Professions Education
Background:
- Spaced repetition is a proven method for enhancing memory consolidation and retrieval.
- Effective educational strategies are crucial for sustained knowledge retention in healthcare professionals.
- The Precede-Proceed Model provides a framework for analyzing educational interventions.
Purpose of the Study:
- To examine how predisposing, enabling, and reinforcing educational strategies support sustained knowledge retention among healthcare professionals.
- To apply the Precede-Proceed Model to analyze the impact of educational strategies on knowledge retention.
- To evaluate the effectiveness of spaced repetition and prior exposure in continuing professional development (CPD) programs.
Main Methods:
- Analysis of three accredited CPD programs (2022-2024) using the Precede-Proceed Model.
- Participants completed pre-test and post-test assessments.
- Learners were stratified by timing and frequency of content exposure.
Main Results:
- Learners accessing content prior to the activity showed a significantly higher mean pre-test score (31%) compared to those viewing it afterward (27%; p=0.041).
- Repeat learners achieved greater knowledge gains (34% improvement; p < 0.001) than first-time learners (26% improvement; p < 0.001).
- Progressive and repeated exposure in CPD programs demonstrated additive value.
Conclusions:
- Strategically structured educational design, incorporating spaced repetition and prior exposure, fosters enduring clinical competence.
- Longitudinal engagement patterns reinforce the importance of proactive learning strategies in professional development.
- Optimizing CPD program design can lead to improved knowledge retention and clinical practice.
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