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.
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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.
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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