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Anesthesia Keyword Engagement Using Spaced Learning Through Mobile Device Platforms
Session: MP-04b
Thurs, Nov. 16, 3:45-5:15 pm
Saybrook Room

Please note, medically challenging cases are removed three months after the meeting and scientific abstracts after three years.

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Anesthesia Keyword Engagement Using Spaced Learning Through Mobile Device Platforms 

Abstract: It is impossible to expose a resident to the innumerable management decisions that can arise in the operating room.  Given clinical demands of anesthesia training and the pressures in an operating room environment, time for learning is sparse.  Efforts should be taken to assess other options at disseminating information.  Spaced learning is an educational concept where objectives repeated over time leads to improved retention and a more efficient learner.  Combining this effort with technology affords an opportunity to expose learners to small snips of information which when repeated, results in superior retention of information. 

We piloted a smartphone based spaced learning process of anesthesia keywords to assess engagement and retention of material outside of our didactic program over three years.  A question bank combined with a delivery algorithm was created based on keywords

Open to any learner, we have had enrollment reach over 350 in the latest module.  Roughly 2/3 of all enrollees participated in the program with an across the board improvement of 40% on the keyword topics covered.  We hope this general anesthesia learning format allows for better retention of information for trainees in the care of patients in the perioperative environment.

Background: It is time-honored that medical trainees cram the night before exams.  While useful for the purpose of passing exams, it does little in facilitating long-term recall.  An exponential loss of recall usually occurs with time.  In fact, a long-held hypothesis called Ebbinghaus’ forgetting curve first noted in 1885 readily explains the transience that occurs (Figure 1).   

As educators, how does one teach students to think critically with a mastery of knowledge? An interesting thing about Ebbinghaus’ hypothesis is that better memory as defined by recall occurs through repeated and spaced exposure of information (Figure 2). Mobile technology provides educator’s an unbelievable avenue to disseminate large amounts of information to learners who can then go through a spaced learning process at their pace to master information.  Preliminary findings by Kerfoot and others have shown promise in this arena, specifically with medical knowledge. 

We developed a technology platform for smartphones and tablets to assess anesthesia residents on medical knowledge via this spaced learning concept and tracked retention rates with utilization of this program.

•We approached anesthesia training programs and requested voluntary participation from trainees.
•Components of each question included: question stem, correct answer along with 3 distractors, explanations of incorrect responses (displayed after initial response), discussion with tables illustrations and references.
•2014 - 51 questions in module 1.  2015 - 39 questions in module 2.  2016 - 60 questions in module 3.
•Technology afforded inclusion of audio and video clips as well as ultrasound imaging.
•Questions were grouped into cohorts of three and sent out to smartphones every three days with initiation of the program.
•Questions answered correctly were resent after 6 days while questions answered incorrectly were resent after 3 days.  All resent questions had their answer sets randomized.
•Questions were retired when answered correctly twice on consecutive attempts.
•We had over 18000 unique responses to the anesthesia question bank. 
•1st attempt success averaged 54% for all learners.  Improvement based on keywords ranged from 40-60% through use of the program.
•Roughly 68% of total registrants participated in this voluntary learning tool while 32% did not.
•Regardless of training center or baseline didactic program, regular spaced intervals of questions with answers attached while allowing for comparison to a cohort resulted in engagement and retention of the information when tested. 


This is potentially transformative in the way anesthesia trainees are exposed to anesthesia information.  This mode of teaching allows education to a broader number of trainees than those who rotate through our center based on spaced learning and provides a framework initiating a massive online open course (MOOC) for the field of anesthesiology.  



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