Novel Spaced Repetition Flashcard System for the In-training Examination for Obstetrics and Gynecology - read online free

Aug 29, 2026

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An electronic flashcard system using retrieval-based practice and spaced repetition was developed to improve obstetrics and gynecology (ob-gyn) in-training examination (ITE) preparation for Duke University residents. A total of 883 flashcards were distributed, and CREOG scores plus internal usage statistics were collected after the 2019 exam. Most residents participated and reported high helpfulness and willingness to recommend the tool. Flashcard use was associated with score improvement from 2018 to 2019, though results were not statistically significant after adjusting for post-graduate year.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

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Introduction

Methods

Results

Discussion

Keywords

Medical Science Educator (2021) 31:1393–1399 [https://doi.org/10.1007/s40670-021-01320-z](https://doi.org/10.1007/s40670-021-01320-z) Novel Spaced Repetition Flashcard System for the In‑training Examination for Obstetrics and Gynecology Shelun Tsai1 · Michael Sun4 · Melinda L. Asbury2,4 · Jeremy M. Weber3 · Tracy Truong3 · Elizabeth Deans1 Accepted: 11 May 2021 / Published online: 19 May 2021 © International Association of Medical Science Educators 2021, corrected publication 2021 Abstract Introduction Electronic flashcards allow repeated information exposure over time along with active recall. It is increasingly used for self-study by medical students but remains poorly implemented for graduate medical education. The primary goal of this study was to determine whether a flashcard system enhances preparation for the in-training examination in obstetricsand gynecology (ob-gyn) conducted by the Council on Resident Education in Obstetrics and Gynecology (CREOG) . Methods Ob-gyn residents at Duke University were included in this study. A total of 883 electronic flashcards were created and distributed. CREOG scores and flashcard usage statistics, generated internally by interacting with the electronic flashcard system, were collected after the 2019 exam. The primary outcome was study aid usage and satisfaction. The secondary outcome was the impact of flashcard usage on CREOG exam scores. Results Of the 32 residents, 31 (97%) participated in this study. Eighteen (58%) residents used the study’s flashcards with a median of 276 flashcards studied over a median of 3.7 h. All of the flashcard users found the study aid helpful, and all would recommend them to another ob-gyn resident. Using the flashcards to study for the 2019 CREOG exam appeared to correlate with improvement in scores from 2018 to 2019, but did not achieve statistical significance after adjusting for post-graduate year (beta coefficient = 10.5; 95% confidence interval = − 0.60,21.7; p = 0.06) . Discussion This flashcard resource was well received by ob-gyn residents for in-training examination preparation, though it was not significantly correlated with improvement in CREOG scores after adjusting for post-graduate year. Keywords Flashcards · Retrieval-based practice · Spaced repetition · In-training examination Introduction Electronic flashcards have become an increasingly popular self-study resource for medical education [1–6] . This method of retrieval-based practice strengthens memory and subse- * Shelun Tsai[stsai6326@gmail.com](stsai6326@gmail.com) 1 Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA 2 Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA 3 Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA 4 Department of Psychiatry, Duke University Medical Center, Durham, NC, USA quent information retention by employing the spacing effect, which states that retention improves with repeated exposure to information over time, and active recall, which stresses the importance of actively stimulating memory instead of passively absorbing information [7, 8] . Employment of these cognitive psychology principles aim to interrupt the natural process of forgetting, and instead improve short-term and long-term knowledge retention [9] . Electronic flashcards have gained popularity in medical schools predominantly as a self-study tool for factual knowledge retention [10, 11] . In particular, Anki, an open-source flashcard platform available on a website, laptop, or cellphone, has the added capability to automate and individualize graduated practice intervals based on user-perceived difficulty [12] . In a study by Deng et al. , Anki usage was correlated with improved performance on the US Medical Licensing Examination (USMLE) Step 1 in a dose-dependent manner [11] . While retrieval practice in the form of electronic

FAQs

What was the main purpose of the flashcard system in this study?

To determine whether an electronic flashcard system improves preparation for the ob-gyn in-training examination conducted by CREOG.

How many flashcards were created and how were outcomes measured?

A total of 883 electronic flashcards were created and distributed. Study aid usage, satisfaction, and CREOG exam scores were collected using internal usage statistics after the 2019 exam.

Did using the flashcards improve CREOG exam scores significantly?

Flashcard use correlated with improvement in scores from 2018 to 2019, but it did not reach statistical significance after adjusting for post-graduate year (p = 0.06).

How did residents perceive the flashcard resource?

Among users, all found the study aid helpful and all would recommend it to another ob-gyn resident.

Aug 29, 2026

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