Using an Adaptive, Self-Directed Web-Based Learning Module to Enhance Residents’ Medical Knowledge Prior to a New Clinical Rotation

Background: The effect of self-directed adaptive learning on internal medicine residents’ knowledge prior to a new clinical rotation is not known. Methods: We developed an adaptive, online, self-directed spaced repetition module and determined the effect on medical knowledge acquisition. We randomized postgraduate year 1 internal medicine residents into two groups. The intervention group (n = 27) received an electronic version of the clinical rotation curriculum as portable document format (PDF) files and participated in the online module, delivered via Moodle, a free, open-source learning management system. The non-intervention group (n = 27) only received the PDF files. All residents participated in a medical knowledge test at baseline and 3 months later. Results: Both groups were similar at study baseline in terms of age, trainee type, years since graduation, results at United States Medical Licensing Examination (USMLE) Step 1, 2, In-Training Examination (ITE), and pre-intervention evaluation. There was a statistically significant improvement in scores on the post-intervention medical knowledge assessment for the intervention group when compared with the non-intervention group (24.2 ± 15.4% vs. 8.6 ± 9.9%, p < 0.001). Conclusion: An online, self-directed, adaptive spaced repetition–learning module can offer a simple and effective method to increase the medical knowledge present at the start of residents’ clinical rotations.