Spaced Retrieval Practice for Student Pharmacists
By Yana Weinstein
(Cover image from freestocks.org, CC0, via Wikimedia Commons)
Earlier this week, Dr. Kate Snyder wrote about how she used strategies for effective learning from cognitive psychology for her horse-riding (if you haven't read that, go down it right now). I can't top that, but I did find an interesting article applying the technique of spaced retrieval practice to student pharmacists.
You probably know that for many brand-name medicines you get prescribed, there is a "generic" or off-brand version of that drug. The generic versions are cheaper than the brand names, and typically have the same effect (though see articles such as (1) for possible reduced effectiveness in the generic relative to the brand name). For example, the brand name "Advil" refers to the generic drug "ibuprofen". Often, there is also more than one brand name for the same generic: Motrin and Nurofen are also commonly-used brand name versions of ibuprofen.
Image by trophygeek (CC BY 2.0) on Flickr
Image by frankieleon (CC BY 2.0) on Flickr
For a pharmacist, knowing the correspondence of brand names to generics is very important, so that substitutions can be made efficiently. In this series of studies (2)/(3), the authors gave Doctorate of Pharmacy (PharmD) students a list of 100 brand-generic medications to learn over the course of a semester. After initially quizzing students on sets of 20 across 5 weeks, the researchers varied the restudy/testing schedule for the rest of the semester.
The list of 100 medications was broken down into 10 sublists of 10 medications, and each sublist was studied according to a different spacing plan. For example, some of the sublists were only studied once; some were studied and then tested shortly thereafter (massed); and some were tested multiple times with various delays in between.
The main conclusion from the first study (2) was that any spaced retrieval plan was better than either only having a restudy opportunity, or massing the restudy and retrieval practice opportunities. In addition, the authors found that a longer delay between two retrieval practice opportunities was best for long-term retention. However, in follow-up studies (3), now the shorter delay between the two retrieval practice opportunities was more effective!
Overall, the authors concluded that the most important thing to consider was that students needed multiple retrieval practice opportunities to sustain learning over a long term, but that the specific delay between those retrieval practice opportunities depended on too many factors to be realistically predictable in any given course.
These results link up well with a lab study that we often talk about in our workshops (4). In this experiment, students learned Swahili-English word pairs in a controlled laboratory environment (i.e., they were not learning this information as part of their education, but just for the experiment). For example, "mashua" in Swahili means "boat", so students would study the word-pair mashua-boat, and later would be expected to retrieve "boat" when prompted with "mashua". After correctly retrieving an English translation, students then did one of the following three things with it (see also the image below):
never studied it again
restudied it again twice
retrieved it again twice
Procedure from Karpicke (2009) Experiment 1
The authors found that dropping the word-pair from study after a successful retrieval, and even restudying that item twice, was not enough to sustain the information for a week at more than 30% accuracy. Meanwhile, retrieving two more times after the initial successful retrieval was almost twice as effective for learning.
References:
(1) Gagne, J. J., Choudhry, N. K., Kesselheim, A. S., Polinski, J. M., Hutchins, D., Matlin, O. S., ... & Shrank, W. H. (2014). Comparative effectiveness of generic and brand-name statins on patient outcomes: a cohort study. Annals of Internal Medicine, 161, 400-407.
(2) Terenyi, J., Anksorus, H., & Persky, A. M. (2018). Impact of Spacing of Practice on Learning Brand Name and Generic Drugs. American Journal of Pharmaceutical Education, 82, 6179.
(3) Terenyi, J., Anksorus, H., & Persky, A. M. (2018). Optimizing the Spacing of Retrieval Practice in the Classroom Setting Using Brand/Generics. American Journal of Pharmaceutical Education.
(4) Karpicke, J. D. (2009). Metacognitive control and strategy selection: deciding to practice retrieval during learning. Journal of Experimental Psychology: General, 138, 469-486.
