NUR 6023 Module 3 Deep Learning Strategy Analysis Example

Rereading Feels Like Learning: Building Retrieval and Spaced Practice Into a Pharmacology Course So That Week Two's Drugs Are Still There in Week Fifteen, and in Medical-Surgical Nursing

Student Name

American College of Education

NUR6023: Transformational Teaching in Nursing Education

Module 3 Assignment

Instructor Name

May 20, 2030

The Forgetting Problem

Pharmacology for Nursing I introduces about 120 drugs over fifteen weeks. Students learn each class, pass the unit examination and move on. At the start of the second pharmacology course, I give a short ungraded quiz on first-course content, and last spring the class average was 54%, compared with an average of 81% on the same items when they were first examined. The medical-surgical faculty report the same thing: students who passed pharmacology cannot recall why a patient on digoxin needs a potassium level. I also surveyed the class on how they study. Of 61 respondents, 49 said their main method was rereading notes or the textbook, 38 highlighted, 22 made summary sheets and only 14 regularly tested themselves with questions or flashcards. Many studied intensively in the two days before each examination. The pattern produces good examination scores and poor retention, which is the opposite of what nursing practice needs.

The Testing Effect

Retrieving information from memory is not only a way of checking learning; it strengthens it. Roediger and Karpicke (2006) asked students to study prose passages and then either take recall tests, without feedback, or restudy the passages for the same amount of time. On a final test five minutes later, the students who had restudied recalled more. But on tests two days or one week later, the students who had practiced retrieval retained substantially more, even though the restudy group felt more confident in their ability to remember. That finding explains my survey. Rereading feels productive because the material becomes familiar, and familiarity is easily mistaken for learning. The strategy that feels best in the week of the examination is the one that serves students worst in the year after it.

The Spacing Effect

The second principle concerns timing. When the same amount of study is spread across sessions rather than massed together, long-term retention improves. A quantitative synthesis of research on distributed practice in verbal recall found consistent benefits of spacing and that the optimal gap between study sessions increases as the interval until the final test grows (Cepeda et al., 2006). For a nursing student, the relevant final test is not the unit examination three weeks away but the medical-surgical course next semester and practice after graduation. Studying a drug class intensively two days before an examination and never again is the massed pattern that research suggests will be forgotten fastest.

Which Techniques Help Most

A review of ten common learning techniques by Dunlosky et al. (2013) rated each for its usefulness across learners, materials, conditions and outcomes. Practice testing and distributed practice received high utility ratings because they benefit learners of different ages and abilities and improve performance across many kinds of task, including in real educational settings. Elaborative interrogation, self-explanation and interleaved practice received moderate ratings, promising but less thoroughly tested. Summarization, highlighting, the keyword mnemonic, imagery for text and rereading received low ratings. The students' three most common methods, rereading, highlighting and summary sheets, are all in the lowest group, and the method used by fewer than a quarter of them, self-testing, is in the highest.

Beyond Recall: Explaining and Mixing

Retrieval and spacing strengthen memory, but nurses need more than recall of facts about drugs. They need to explain why a finding matters and to tell similar drugs apart. Two of the moderate-utility techniques in the same review address those needs, and I will use them with the caution their rating implies. Self-explanation and elaborative interrogation ask learners to say why a fact is true or how it connects to what they know (Dunlosky et al., 2013). In pharmacology that means asking not only what laboratory value to check before giving digoxin, but why low potassium makes digoxin toxicity more likely. Some of the quiz items and every start-of-class retrieval task will include a why question, so that students retrieve the mechanism as well as the fact.

Interleaving, mixing different kinds of problems in the same practice session rather than practicing one kind at a time, has an obvious application in pharmacology, where students confuse drugs with similar names or effects. A quiz that asks about beta blockers, calcium channel blockers and digoxin in one sequence forces students to decide which drug a question is about before answering, which is the discrimination they will need at the medication cart. The weekly quizzes will mix classes in this way from the fourth week onward. Because the evidence for both techniques is thinner than for testing and spacing, I will treat them as additions to the core design rather than its foundation, and I will look at whether items requiring explanation or discrimination improve as much as simple recall items.

Redesigning the Semester

The redesign has four parts. First, weekly cumulative quizzes. Each week's online quiz will contain ten items: five on the current week's drugs and five drawn from earlier weeks, with the earlier items chosen so that each drug class returns at increasing intervals, one week, then three weeks, then six. The quizzes are open for three days, allow two attempts with feedback after each and together count for 5% of the grade, enough to encourage completion without raising the stakes. Second, retrieval at the start of every class. The first five minutes of each session will be a closed-book written recall task: list three nursing assessments for a drug class taught earlier in the semester, then compare with a neighbor. Third, cumulative examinations. Each unit examination will include 20% of items from earlier units, so that earlier content never stops mattering. Fourth, teaching students how to learn. In the first week, I will spend twenty minutes on the testing and spacing effects, including a short demonstration in which the class learns ten drug names by two methods and is tested a week later, and I will provide a drug card template designed for self-testing rather than rereading.

The changes cost little class time, about five minutes a week, and use tools the college already has. The larger cost is preparation: writing a bank of about 300 quiz items and scheduling their return. I will build the bank over the summer and share it with the colleague who teaches the other section.

Measuring Retention, Not Performance

Because the goal is long-term retention, the evaluation must look beyond this course. I will repeat the ungraded quiz at the start of the second pharmacology course and compare the class average with last spring's 54%, using the same items. On the final examination, I will compare performance on items from the first four weeks with last year's cohort. I will repeat the study-habits survey at the end of the semester to see whether self-testing has increased. And I will ask the medical-surgical faculty to give a short pharmacology recall quiz in the first week of their course, which will show whether the gains last into the next semester. If retention improves but examination scores fall, which the research suggests is possible in the short term because retrieval is harder than rereading, I will report both and explain why the trade is worth making.

References

Cepeda, N. J., Pashler, H., Vul, E., Wixted, J. T., & Rohrer, D. (2006). Distributed practice in verbal recall tasks: A review and quantitative synthesis. Psychological Bulletin, 132(3), 354-380. https://doi.org/10.1037/0033-2909.132.3.354

Dunlosky, J., Rawson, K. A., Marsh, E. J., Nathan, M. J., & Willingham, D. T. (2013). Improving students' learning with effective learning techniques: Promising directions from cognitive and educational psychology. Psychological Science in the Public Interest, 14(1), 4-58. https://doi.org/10.1177/1529100612453266

Roediger, H. L., III, & Karpicke, J. D. (2006). Test-enhanced learning: Taking memory tests improves long-term retention. Psychological Science, 17(3), 249-255. https://doi.org/10.1111/j.1467-9280.2006.01693.x