Skip to main content

Long-term retention of basic science knowledge: a review study

Abstract

In this paper, a review of long-term retention of basic science knowledge is presented. First, it is argued that retention of this knowledge has been a long-standing problem in medical education. Next, three types of studies are described that are employed in the literature to investigate long-term retention of knowledge in general. Subsequently, first the results of retention studies in general education are presented, followed by those of studies of basic science knowledge in medical education. The results of the review, in the general educational domain as well as in medical education, suggest that approximately two-third to three-fourth of knowledge will be retained after one year, with a further decrease to slightly below fifty percent in the next year. Finally, some recommendations are made for instructional strategies in curricula to improve long term retention of the subject matter dealt with.

This is a preview of subscription content, access via your institution.

Fig. 1

Notes

  1. It should be noted that we do not think there is any fundamental difference between basic science knowledge and clinical knowledge in terms of retentivity. Level of retention of clinical knowledge will be influenced by thoroughness of initial learning (exposure), length of the retention interval, and reinforcement during the retention interval. Probably, this latter factor will account for most of the differences in retention between basic science and clinical knowledge; in fact, for much clinical knowledge, the assumption of a nonuse retention interval (no reinforcement or rehearsal) may be difficult to maintain. For example, Hojat and Veloski (1984) found an inverse relationship between students’ scores on NBME Part II psychiatry, gynecology/obstetrics, and surgery subtests and the time lapsed since they attended the corresponding clerkships, but no relationship between their knowledge of general internal medicine at the examination and the time that had passed since they attended the internal medicine clerkship. Hojat and Veloski (1984) attribute this to knowledge of general medicine being pervasively used during most clerkships, hence being reinforced or rehearsed regularly. Conversely, clinical knowledge and basic science knowledge that remain unused will suffer from similar attrition or decay.

References

  • Allen, R., & Reber, A. S. (1980). Very long-term memory for tacit knowledge. Cognition, 8, 175–185.

    Article  Google Scholar 

  • Anderson, J. (1993). The continuum of medical education: The role of basic medical sciences. Journal of the Royal College of Physicians of London, 27(4), 405–407.

    Google Scholar 

  • Arthur, W. Jr., Bennett, W. Jr., Stanush, P. L., & McNelly, Th. L. (1998). Factors that influence skill decay and retention: A quantitative review and analysis. Human Performance, 11(1), 57–101.

    Article  Google Scholar 

  • Arzi, H. J., Ben-Zvi, R., & Ganiel, U. (1985). Proactive and retroactive facilitation of long term retention by curriculum continuity. American Educational Research Journal, 22(3), 369–388.

    Article  Google Scholar 

  • Arzi, H. J., Ben-Zvi, R., & Ganiel, U. (1986). Forgetting versus savings: The many facets of long-term retention. Science Education, 70(2), 171–188.

    Article  Google Scholar 

  • Bahrick, H. P. (1979). Maintenance of knowledge: Questions about memory we forgot to ask. Journal of Experimental Psychology: General, 108, 296–308.

    Article  Google Scholar 

  • Bahrick, H. P. (1984). Semantic memory content in permastore: Fifty years of memory for Spanish learned in school. Journal of Experimental Psychology: General, 113(1), 1–29.

    Article  Google Scholar 

  • Bahrick, H. P. (1992). Stabilized memory of unrehearsed knowledge. Journal of Experimental Psychology: General, 121(1), 112–113.

    Article  Google Scholar 

  • Bahrick, H. P. (1993). Extending the life span of knowledge. In L. A. Penner, G. M. Batsche, H. M. Knoff, & D. L. Nelson (Eds.), The challenge in mathematics and science education: Psychology’s response (pp. 61–82). Washington, DC, USA: American Psychological Association.

    Chapter  Google Scholar 

  • Bahrick, H. P. (2000). Long-term maintenance of knowledge. In E. Tulving & F. I. M. Craik (Eds.), The oxford handbook of memory (pp. 347–362). New York: Oxford University Press.

    Google Scholar 

  • Bahrick, H. P., & Hall, L. K. (1991a). Lifetime maintenance of high school mathematics content. Journal of Experimental Psychology: General, 120, 20–33.

    Article  Google Scholar 

  • Bahrick, H. P., & Hall, L. K. (1991b). Preventive and corrective maintenance of access to knowledge. Applied Cognitive Psychology, 5, 1–18.

    Article  Google Scholar 

  • Bahrick, H. P., & Phelps, E. (1987). Retention of Spanish vocabulary over eight years. Journal of Experimental Psychology: Learning, Memory, and Cognition, 13(2), 344–349.

    Google Scholar 

  • Bangert-Drowns, L. L., Kulik, J. A., & Kulik, C. L. C. (1991). Effects of frequent classroom testing. Journal of Educational Research, 85(2), 89–99.

    Article  Google Scholar 

  • Bassett, S. J. (1929). Factors influencing retention of history in the sixth, seventh, and eighth grades. Journal of Educational Psychology, 20, 683–691.

    Article  Google Scholar 

  • Bethe, A. (1928). Kritische Betrachtungen über den vorklinischen Unterricht. [Critical observations on preclinical education]. Klinische Wochenschrift, 7(31), 1481–1483.

    Article  Google Scholar 

  • Blizard, P. J., Carmody, J. J., & Holland, R. A. B. (1975). Medical students’ retention of knowledge of physics and biochemistry on entry to a course in physiology. British Journal of Medical Education, 9, 249–254.

    Article  Google Scholar 

  • Blunt, M. J., & Blizard, P. J. (1975). Recall and retrieval of anatomical knowledge. British Journal of Medical Education, 9, 255–263.

    Article  Google Scholar 

  • Briggs, L. .J., & Reed, H. B. (1943). The curve of retention for substance material. Journal of Experimental Psychology, 32(6), 513–517.

    Article  Google Scholar 

  • Brooks, F. D., & Bassett, S. J. (1928). The retention of American history in the junior high school. Journal of Educational Research, 18, 195–202.

    Article  Google Scholar 

  • Cederstrom, J. A. (1930). Retention of information gained in courses in college zoology. Journal of Genetic Psychology, 38(December), 516–520.

    Google Scholar 

  • Christina, R. W., & Bjork, R. A. (1991). Optimizing long-term retention and transfer. In D. Druckman & R. A. Bjork (Eds.), In the mind’s eye: Enhancing human performance (pp. 23–56). Washington, DC: National Academy Press.

    Google Scholar 

  • Cole, L. (1932). What is wrong with the medical curriculum? VIII. The Lancet, 110(July 30), 253–254.

    Article  Google Scholar 

  • Conway, M. A., Cohen, G., & Stanhope, N. (1991). On the very long-term retention of knowledge acquired through formal education: Twelve years of cognitive psychology. Journal of Experimental Psychology: General, 120(4), 395–409.

    Article  Google Scholar 

  • Conway, M. A., Cohen, G., & Stanhope, N. (1992). Very long-term memory for knowledge acquired at school and university. Applied Cognitive Psychology, 6(6), 467–482.

    Article  Google Scholar 

  • Day, S. C., Norcini, J. J., Webster, G. D., Viner, E. D., & Chirico, A. M. (1988). The effect of changes in medical knowledge on examination performance at the time of recertification. Proceedings of the Annual Conference on Research in Medical Education, 27, 139–144.

    Google Scholar 

  • D’Eon, M. F. (2006). Knowledge loss of medical students on first year basic science courses at the University of Saskatchewan. BMC Medical Education, 6(5).

  • Donovan, J. C., Salzman, L. F., & Allen, P. Z. (1969). Patterns of learning in medical school. Journal of Medical Education, 44(7), 589–594.

    Google Scholar 

  • Dornhorst, A. C., & Hunter, A. (1967). Fallacies in medical education. Lancet, II(23 Sep), 666–667.

    Article  Google Scholar 

  • DuBois, A. B., Nemir, P. Jr., Schumacher, C. F., & Hubbard, J. P. (1969). Graduate medical education in basic sciences. Journal of Medical Education, 44(11), 1035–1043.

    Google Scholar 

  • Ebbinghaus, H. (1966). Über das Gedächnis. Untersuchungen zur Experimentellen Psychologie. Nachdruk der Ausgabe Leipzig 1885. Amsterdam, Netherlands: E. J. Bonset. [English text avaiable at http://psychclassics.yorku.ca/Ebbinghaus/index.htm]

  • Eikenberry, D. H. (1923). Permanence of high school learning. Journal of Educational Psychology, 14, 463–481.

    Article  Google Scholar 

  • Ellis, J. A., Semb, G. B., & Cole, B. (1998). Very long-term memory for information taught in school. Contemporary Educational Psychology, 23, 419–433.

    Article  Google Scholar 

  • Eurich, A. C. (1934). Retention of knowledge acquired in a course in general psychology. Journal of Applied Psychology, 18, 209–219.

    Article  Google Scholar 

  • Farr, M. J. (1987). The long-term retention of knowledge and skills. A cognitive and instructional perspective. New York: Springer-Verlag.

    Book  Google Scholar 

  • Frutchey, F. P. (1937). Retention in high school chemistry. Educational Research Bulletin, 16, 34–37.

    Google Scholar 

  • Glasnapp, D. R., Poggio, J. P., & Ory, J. C. (1978). End-of-course and long-term retention outcomes for mastery and nonmastery learning paradigms. Psychology in the Schools, 15(4), 595–603.

    Article  Google Scholar 

  • Greene, E. B. (1931). The retention of information learned in college courses. Journal of Educational Research, 24, 262–273.

    Article  Google Scholar 

  • Harrison, A. (1995). Using knowledge decrement to compare medical students’ long-term retention of self-study and lecture materials. Assessment and Evaluation in Higher Education, 20(2), 149–159.

    Article  Google Scholar 

  • Herzig, S., Linke, R.-M., Marxen, B., Borner, U., & Antepohl, W. (2003). Long-term follow up of factual knowledge after a single, randomised problem-based learning course. BMC Medical Education, 3(3).

  • Higbee, K. L. (1977). Your memory: How it works and how to improve it. Englewood Cliffs, NJ: Prentice Hall.

    Google Scholar 

  • Hojat, M., & Veloski, J. J. (1984). Subtest scores of a comprehensive examination of medical knowledge as a function of retention interval. Psychological Reports, 55, 579–586.

    Article  Google Scholar 

  • Holcomb, J. D., Carbonari, J., Nelson, J., & Wylie, L. (1982). The evaluation of a cardiovascular school health curriculum: An assessment of long-term cognitive retention and attitudinal correlates. Journal of School Health, 52(8), 378–383.

    Article  Google Scholar 

  • Hovland, C. I. (1951). Human learning and retention. In S. S. Stevens (Ed.), Handbook of experimental psychology (pp. 613–689). New York: Wiley.

    Google Scholar 

  • Johnson, P. O. (1930). The permanence of learning in elementary botany. Journal of Educational Psychology, 21(January), 37–47.

    Article  Google Scholar 

  • Kastrinos, W. (1965). A study of the retention of biological facts by high school biology students. Science Education, 49, 487–491.

    Article  Google Scholar 

  • Kennedy, W. B., Kelley, P. R., & Saffran, M. (1981). Use of NBME examinations to assess retention of basic science knowledge. Journal of Medical Education, 56, 167–173.

    Google Scholar 

  • Kerfoot, B. P., Baker, H., Jackson, T. L., Hulbert, W. C., Federman, D. D., Oates, R. D., & DeWolf, W. C. (2006). A multi-institutional randomized controlled trial of adjuvant web-based teaching to medical students. Academic Medicine, 81(3), 224–230.

    Article  Google Scholar 

  • Kerfoot, B. P., DeWolf, W. C., Masser, B. A., Church, P. A., & Federman, D. D. (2007). Spaced education improves the retention of clinical knowledge by medical students: a randomised controlled trial. Medical Education, 41, 23–31.

    Article  Google Scholar 

  • Koens, F., Ten Cate, Th. J., & Custers, E. J. F. M. (2003). Context-dependent memory in a meaningful environment for medical education: In the classroom and at the bedside. Advances in Health Sciences Education, 8(2), 155–165.

    Article  Google Scholar 

  • Krebs, R., Guilbert, J. J., Hofer, R., & Bloch, R. (1997). Retention and forgetting of biological facts and concepts, learnt for the first basic science exam, over a two year period. In A. J. J. A. Scherpbier, C. P. M. Van Der Vleuten, J. J. Rethans, & A. F. W. Van Der Steeg (Eds.), Advances in medical education (pp. 162–165). Dordrecht, The Netherlands: Kluwer Academic Publishers.

    Chapter  Google Scholar 

  • Landauer, T. K., & Ainslie, K. I. (1975). Exams and use as preservatives of course-acquired knowledge. Journal of Educational Research, 69, 99–105.

    Article  Google Scholar 

  • Landauer, T. K., & Bjork, R. A. (1978). Optimal rehearsal patterns and name learning. In M. M. Gruneberg, P. E. Morris, & R. N. Sykes (Eds.), Practical aspects of memory (pp. 625–632). San Diego, CA: Academic Press.

    Google Scholar 

  • Lazic, E., Dujmovic, J., & Hren, D. (2006). Retention of basic sciences knowledge at clinical years of medical curriculum. Croatian Medical Journal, 47, 882–997.

    Google Scholar 

  • Levine, H. G., & Forman, P. M. (1973). A study of retention of knowledge of neurosciences information. Journal of Medical Education, 48, 867–869.

    Google Scholar 

  • McKeachie, W. J., & Solomon, D. (1957). Retention of general psychology. Journal of Educational Psychology, 48, 110–112.

    Article  Google Scholar 

  • Miller, G. E. (1962). An inquiry into medical teaching. Journal of Medical Education, 37(3), 185–191.

    Google Scholar 

  • Miller, G. E., Graser, H. P., Abrahamson, S., Harnack, R. S., Cohen, I. S., & Land, A. (1961). Teaching and learning in medical school. Cambridge, MA: Harvard University Press.

    Book  Google Scholar 

  • Mitchell, D. B. (2006). Nonconscious priming after 17 years: Invulnerable implicit memory. Psychological Science, 17(11), 925–929.

    Article  Google Scholar 

  • Naveh-Benjamin, M. (1990). The acquisition and retention of knowledge: Exploring mutual benefits to memory research and the educational setting. Applied Cognitive Psychology, 4, 295–320.

    Article  Google Scholar 

  • Neame, R. L. (1984). The preclinical course of study: help or hindrance? Journal of Medical Education, 59(9), 699–707.

    Google Scholar 

  • Neisser, U. (1984). Interpreting Harry Bahrick’s discovery: What confers immunity against forgetting? Journal of Experimental Psychology: General, 113(1), 32–35.

    Article  Google Scholar 

  • Neville, A. J. (2000). The state of play in 1999: Basic science and medical education: dinosaurs, departments and definitions—A McMaster view. Clinical and Investigative Medicine, 23(1), 30–34.

    Google Scholar 

  • Norman, G. R. (2000). Where we want to be by 2010: The essential role of basic science in medical education: the perspective from psychology. Clinical and Investigative Medicine, 23(1), 47–51.

    Google Scholar 

  • Powers, S. R. (1925). How long do students retain what they have learned from high school chemistry? Journal of Chemical Education, 2, 174–180.

    Article  Google Scholar 

  • Rea, C. P., & Modigliani, V. (1988). Educational implications of the spacing effect. In M. M. Gruneberg, P. E. Morris, & R. N. Sykes (Eds.), Practical aspects of memory: Current research and issues. Vol. 1.: Memory in everyday life (pp. 402–406). New York: John Wiley & Sons.

    Google Scholar 

  • Rickard, H. C., Rogers, R., Ellis, N. R., & Beidleman, W. B. (1988). Some retention, but not enough. Teaching of Psychology, 15(3), 151–152.

    Article  Google Scholar 

  • Rico, E., Galindo, J., & Marset, P. (1981). Remembering biochemistry: A study of the patterns of loss of biochemical knowledge in medical students. Biochemical Education, 9, 100–102.

    Article  Google Scholar 

  • Roediger, H. L. III, & Karpicke, J. D. (2006). The power of testing memory. Basic research and implications for educational practice. Perspectives on Psychological Science, 1(3), 181–210.

    Article  Google Scholar 

  • Rodriguez, R., Campos-Sepulveda, E., Vidrio, H., Contreras, E., & Valenzuela, F. (2002). Evaluating knowledge retention of third-year medical students taught with an innovative pharmacology program. Academic Medicine, 77(6), 574–577.

    Article  Google Scholar 

  • Saffran, M., Kennedy, W., & Kelley, P. (1981). Use of National Board examinations to estimate retention of biochemistry. Biochemical Education, 9(3), 97–99.

    Article  Google Scholar 

  • Saffran, M., Kennedy, W. B., & Kelley, P. R. (1982). Retention of knowledge of pharmacology by U.S. and Canadian medical students. Trends in Pharmacological Sciences, 3, 461–463.

    Article  Google Scholar 

  • Semb, G. B., & Ellis, J. A. (1994). Knowledge taught in school: What is remembered? Review of Educational Research, 64, 253–286.

    Article  Google Scholar 

  • Semb, G. B., Ellis, J. A., & Araujo, J. (1993). Long-term memory for knowledge learned in school. Journal of Educational Psychology, 85(2), 305–316.

    Article  Google Scholar 

  • Schmidt, H. G., Peeck, V. H., Paas, F., & Van Breukelen, G. J. P. (2000). Remembering the street names of one’s childhood neighbourhood: A study of very long-term retention. Memory, 8(1), 37–49.

    Article  Google Scholar 

  • Schmidt, R. A., & Bjork, R. A. (1992). New conceptualizations of practice: Common principles in three paradigms suggest new concepts for training. Psychological Science, 3, 207–217.

    Article  Google Scholar 

  • Schwartz, P. L. (1981). Retention of knowledge in clinical biochemistry and the effect of the Keller Plan. Journal of Medical Education, 56, 779–781.

    Google Scholar 

  • Shulman, L. J. (1970). Cognitive learning and the educational process. Journal of Medical Education, 45(Nov.-Suppl.), 401–413.

    Google Scholar 

  • Sinclair, D. (1965). An experiment in the teaching of anatomy. Journal of Medical Education, 40, 401–413.

    Google Scholar 

  • Sisson, J. C., Swartz, R. D., & Wolf, F. M. (1992). Learning, retention, and recall of clinical information. Medical Education, 26, 454–461.

    Article  Google Scholar 

  • Stroud, J. B. (1940). Experiments on learning in school situations. Psychological Bulletin, 37, 777–807.

    Article  Google Scholar 

  • Swanson, D. B., Case, S. M., Luecht, R. M., & Dillon, G. F. (1996). Retention of basic science information by fourth-year medical students. Academic Medicine, 71(Oct. Suppl.), S80–S82.

    Article  Google Scholar 

  • Tyler, R. W. (1930). What high-school pupils forget. Educational Research Bulletin, 9, 490–492.

    Google Scholar 

  • Tyler, R. W. (1933). Permanence of learning. Journal of Higher Education, 4, 203–204.

    Article  Google Scholar 

  • Tyler, R. W. (1949). Basic principles of curriculum and instruction. Chicago: The University of Chicago Press.

    Google Scholar 

  • Watt, M. E. (1987). Retention of preclinical knowledge by clinical students. Medical Education, 21, 119–124.

    Article  Google Scholar 

  • Weitman, M. (1964). A study of long-term retention in medical students. The Journal of Experimental Education, 33(1), 87–91.

    Article  Google Scholar 

  • Wert, J. E. (1937). Twin examination assumptions. Journal of Higher Education, 8(3), 136–140.

    Article  Google Scholar 

  • Wickelgren, W. A. (1972). Trace resistance and the decay of long-term memory. Journal of Mathematical Psychology, 9(4), 418–455.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eugène J. F. M. Custers.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Custers, E.J.F.M. Long-term retention of basic science knowledge: a review study. Adv in Health Sci Educ 15, 109–128 (2010). https://doi.org/10.1007/s10459-008-9101-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10459-008-9101-y

Keywords

  • Basic science knowledge
  • Long term retention
  • Review study