A Randomized Educational Interventional Trial of Spaced Education During a Pediatric Rotation

Objective: Spacing of educational material over time has been shown to improve learning efficiency and long-term knowledge retention. We evaluated the impact of adding a spaced education curriculum to a month-long pediatric rotation. Methods: This was a randomized controlled educational intervention trial of residents on a rotation in a pediatric emergency department. Participants were randomized to the standard curriculum or the standard curriculum with integrated spaced education. The intervention used an automated platform to electronically deliver questions to user e-mail or mobile devices and provided instant feedback. Our primary outcome was proportion of correctly answered questions following the rotation. Our secondary outcomes included test performance at 3 months, change in clinical confidence, and satisfaction with the spaced learning. Learner opinion of the platform was assessed by postrotation survey. Results: Of 194 eligible trainees, 122 were enrolled and randomized. A total of 107 of the enrolled residents (88%) completed the immediate postrotation assessment, 48 of whom received spaced education. Sixty residents completed the 3-month follow-up. There were no differences between the control and intervention groups in baseline knowledge. The intervention group performed better than the control group on the postrotation assessment (mean difference = 5.4%, 95% confidence interval = 0.1–10.7) when controlled for didactic attendance and clinical exposure. Change in confidence did not differ between groups. Eighty-seven percent of spaced education learners would participate in a similar model in the future. Conclusion: Spaced education during a pediatric emergency medicine rotation is an effective adjunct to a standard curriculum. Participants showed improvement on postrotation knowledge performance and enjoyed this educational approach.