Retention of basic and clinical concepts in Anatomy and the effect of multiple testing

Abstract

Background: Clinical competency depends on student's knowledge of basic sciences including the learned
concept in Anatomy. But what if students forget the learned knowledge of human anatomy?

Objectives: This research investigated knowledge gain post instruction, knowledge retention (or loss) of basic and clinical concepts five months after. It also compared the effect of delayed-multiple testing and delayedsingle testing in the retention of acquired knowledge.

Methodology: This is an experimental study conducted among first year medical students who underwent
neuroanatomy module and later followed-up after five months using a 32-item test-retest. Items were
categorized as basic knowledge and clinical correlation. Participants were randomly assigned into two groups; delayed-multiple and delayed-single testing. Mean difference in scores between the 2 testing periods (end-ofmodule and terminal delayed test) were analyzed using paired samples t-test while mean difference between basic and clinical correlation were analyzed using independent samples t-test. The degree of knowledge loss was determined using the computed Knowledge Loss Percentage (KLP).

Results: Knowledge gain was noted at the end of instruction (p value<0.001). Knowledge loss is higher among basic knowledge (p value<0.001) and demonstrated a higher computed KLP. Repeated testing demonstrates a higher retention (KLP=4.34) compared to those administered with a single test only (KLP=26.73).

Conclusion: Knowledge loss occurs post instruction and more pronounced among basic concepts. Clinical correlation and frequent testing demonstrate a significant retention capability. To reduce the effect of knowledge loss among basic concepts, this study recommends the implementation of multiple testing.