Learning benefits of on-line spaced education persist for 2 years

J Urol. 2009 Jun;181(6):2671-3. doi: 10.1016/j.juro.2009.02.024. Epub 2009 Apr 16.


Purpose: A total of 537 urology residents participated in a randomized trial of on-line spaced education in 2005 that used 96 American Urological Association Self-Assessment Study Program questions as educational material. I investigated whether the learning gains generated by the spaced education program could be detected 2 years later.

Materials and methods: A test instrument was constructed with 60 of the 96 Self-Assessment Study Program questions from the 2005 trial. These multiple choice questions were delivered to residents from September to November 2007 via daily interactive e-mails. Residents submitted answers on line and were included in analysis if they completed 85% or greater of the questions.

Results: Of the 537 residents in the 2005 trial 206 (38%) were still in residency and volunteered to complete the test. Of those residents 104 (50%) were randomized to the spaced education cohort, 102 (50%) were randomized to the bolus cohort and 147 (71%) submitted answers to 85% or greater of the test questions. There were no significant differences in age, gender, degree or training year between the cohorts. Residents in the spaced education cohort had significantly greater test scores than residents in the bolus cohort (mean +/- SD 70.2% +/- 9.0% vs 66.8% +/- 10.6%, effect size 0.35, p = 0.03).

Conclusions: On-line spaced education can generate improvements in learning that are retained 2 years later. Although the effect size is modest, the persistence of detectable knowledge differences between educational interventions after such a long duration is exceedingly unusual. Further research is needed to determine how spaced education can best be used to optimize lifelong learning for urologists.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Educational Measurement
  • Electronic Mail
  • Female
  • Humans
  • Internship and Residency / methods*
  • Male
  • Retention, Psychology*
  • Surveys and Questionnaires
  • Time Factors
  • Urology / education*