Episode 94: Retrieval Practice in the Health Professions

0:00Welcome to the Learning Scientist podcast, a podcast for teachers, students, and parents about evidence-based practice and learning. This is Althea Neet-Kaminski for the Learning Scientists. In today's podcast, I'll be reading the blog, Retrieval Practice in the Health Professions. A quick note before we begin, that the following describes health professions education specifically within the U.S. As a learning scientist interested in how learning works, health professions education

0:31is an exciting and dynamic environment to explore best practices and the application of the principles and strategies that we study in cognitive psychology. Recently, Cindy and I published a paper entitled, The Use of Retrieval Practice in the Health Professions, a State-of-the-Art Review, along with two other cognitive psychologists who work as medical education learning specialists, or MELS, Michael J. Serra and Kristen M. Coppola. In this post, I want to summarize two sections from the paper, why health professions have embraced retrieval practice and barriers and challenges to effective use of retrieval practice

1:04in health professions. Why have the health professions embraced retrieval practice? One thing that surprised me when I started my role as a MELS was that I didn't really have to sell people on using retrieval practice. Students assured me that they knew the value of practice and recall, and my MD colleagues were somewhat well-read on the topic, many having read books like Make It Stick, or about retrieval practice within medical education journals. In our recent paper, we wanted to explore why that was, and we settled on four reasons.

1:35First, the fast-paced and high volume of content in the health professions, combined with high-stakes licensing exams, particularly within medical education, necessitates the use of highly effective strategies. Retrieval practice yields such obvious benefits to learning and retention that it makes sense that the health professions would find it incredibly useful. Second, health profession students are highly motivated to find ways to make their studying as efficient as possible. The amount of basic science information that a health profession student has to know is only

2:06ever-increasing, but the length of time that they have in training remains the same. At the same time, there is immense pressure to perform well in licensing exams. Poor performance can lead to costly delays, no small amount of stigma, and even dismissal from a program. An entire market for third-party resources to help optimize studying and prepare for tests has developed in response. Among medical students, flashcard programs like Anki, question banks like UWorld, Amboss, or TrueLearn, and video explainers like Sketchy are popular.

2:37All of these programs rely on retrieval practice, based practice, and, in the case of Sketchy, imagery to improve learning. Anki, in particular, uses a spaced repetition algorithm, currently SuperMemo 2 and FSRS, to determine when you should practice retrieval with material to optimize retention based on past performance. So, when I say that medical students are motivated to make studying as efficient as possible, I mean that they are willing to pay hundreds of dollars for access to additional resources for retrieval practice or to learn how to navigate open-source software.

3:10Third, somewhat paradoxically, despite the high admission standards for health professions programs, a large portion of students lack strong study skills and habits. A recent study of medical students found that half fell below average on measures of self-regulated learning. In my experience, those who lack strong study skills have either brute-forced their way through ineffective study habits or had enough background knowledge or experience that they were not sufficiently challenged until medical school. This, combined with the fast pace and high volume of information within health professions

3:42education, perhaps explains why health professions are so highly motivated to seek out retrieval practice. Finally, and perhaps most compelling, at least for me, is the simple fact that retrieval practice is a very easy strategy to use. It's one of many tools that any student needs to be successful, but it's also a pretty versatile tool and improves comprehension, long-term memory, and provides real-time, objective feedback on performance. While students may come into health professions with a range of ability in self-regulated learning,

4:13see above, effective use of retrieval practice can be a valuable component of the development of self-regulated learning. Barriers or Challenges to Effective Use of Retrieval Practice in the Health Professions Despite the advantages of retrieval practice, particularly within the health professions as outlined above, students may still be hesitant to engage in retrieval practice. One simple reason is that while retrieval practice is more well-known among researchers and educators, students may not always be aware of it, though a recent study by Witherby et al. in 2025 showed that undergraduate psychology students rated retrieval practice as the most effective strategy,

4:48so there's evidence that this may be changing. Additionally, while students may be aware of retrieval practice in broad terms, they may have limited knowledge about how to best use retrieval practice or any of the nuances of the application of retrieval practice. For example, Sheehy et al., 2024, found that students may choose to look up the answer when they are unsure, rather than trying to retrieve it from memory, or only choose to use retrieval practice for items that they missed in practice. Both of these strategies indicate that students are unaware of best practices around retrieval practice

5:21and may be experiencing limited benefits of retrieval practice. This lack of understanding about the nuances of retrieval practice could lead to misleading experiences of retrieval practice. Students may rely on forms of retrieval practice that are not appropriate for their learning goal and therefore assume that lack of progress towards these goals is due to the retrieval practice. For example, students heavily use flashcard software like Anki to prepare for exams. This use of flashcards is highly effective when exams focus on low-level facts, but may not yield the level of comprehension necessary for exams that focus on higher-order inferences.

5:56Instead, retrieval practice using question banks that more closely align with the types of questions posed on the exam would likely be more beneficial for improving exam performance. A final challenge to students using retrieval practice is negative beliefs about testing and errors. It is worth noting that medical students experience academic shame around poor performance, leading to reduced help-seeking behavior. Students may be hesitant to use retrieval practice because they worry that errors signal that they not only don't know the material, but perhaps are unfit for their program, feelings that can be related to imposter syndrome.

6:30By and large, health professions education have embraced retrieval practice. In many ways, health professions are ideally suited for fast adoption of retrieval practice, as it helps to optimize learning under rather stringent conditions of health professions education. While the health professions make frequent use of retrieval practice, there is still work to be done to address the barriers and challenges to effective and efficient use of this learning strategy. This episode is funded by listeners like you. To support our work and gain access to exclusive content, visit our Patreon page at www.patreon.com slash learningscientists.