Utilization Patterns and Perceptions of a Spaced Repetition Flashcard Program, Anki, Among First-Year Medical...

Medical students often turn to external resources to optimize their learning efficiency due to vast amounts of information. A popular resource is Anki (Ankitects Pty Ltd., New South Wales, Australia) a free, open-source flashcard program that leverages spaced repetition to enhance learning and retention. Studies have shown that spaced education enhances knowledge retention in medical education; however, few have specifically examined Anki's usage patterns and perceptions to identify potential interventions that could help enhance learning outcomes. The purpose of this study was to determine usage patterns and student perceptions of how they utilize Anki. Furthermore, this study looked at a deeper level of how students incorporated it into their lives outside of school.  Methods: First-year medical students at the University of Central Florida College of Medicine were recruited to participate in a survey. Deidentified demographic data were gathered, and the survey was open to both Anki and non-Anki users and incorporated question responses using the Likert scale. For Anki users, the survey examined their Anki usage structure, perceptions of Anki, and Anki in relation to life activities. Survey questions were created based on prior Anki experience and adapted from various topics on validated burnout surveys. Seventy-four percent of the first-year class participated in the survey. Quantitative analysis was performed using descriptive statistics and correlation tests on SPSS.

Most students identified as Anki users (94%), emphasizing its role in medical education, and most users relied on pre-made cards (97.6%) and considered Anki as a key study strategy (62.6%). Most students preferred fill-in-the-blank cards (78%), 59% believed Anki boosted productivity compared to other study tools, and a substantial majority (87.8%) believed that Anki significantly contributes to their success in modules. Anki also affected "everyday" life activities. A majority (56.6%) reported multitasking with Anki during activities like exercising or eating. In addition, a Pearson correlation test revealed that the higher the percent study strategy of Anki, the stronger the perception of success (r= 0.621, p<0.001).  Conclusion: Most medical students use Anki as part of their study strategy. Faculty may be able to utilize these insights to optimize the implementation of Anki in medical education by helping students understand how to best utilize Anki's best practices. Future research could further explore students' reasons for how they use this resource.