PURPOSE
Medical schools often rely on practice questions to help students succeed
on high-stakes exams, assuming questions are sufficient to improve scores.
Existing research on study strategies is largely correlational and
inconsistent. Our study uses a design aimed at identifying causal
relationships between strategies and score improvements. We asked: How do
pretest vs posttest score increases differ when studying with practice
questions alone compared to questions supplemented with content review or
retrieval practice?
METHODS
We randomized 66 first- and second-year medical students into three groups:
Practice Questions only (P), Practice Questions + Content Review (PC), and
Practice Questions + Retrieval Practice (PR). Participants completed a
14-item AMBOSS pretest, three proctored 45-minute study sessions over three
days, and a 21-item posttest seven days later. The study material focused on
musculoskeletal pathology using AMBOSS practice questions and review
articles. Group PC and PR split their time equally between methods while
Group P used all their time for questions. ANOVA and Tukey’s HSD were used to
compare pre- and posttest scores. Recruitment was challenged by students’
heavy workloads.
RESULTS
We expected findings to align with literature showing practice questions
alone are less effective than when combined with supplemental strategies. Our
results guide students toward efficient strategies that improve retention.
These results may generalize to other fields relying on practice questions
for high-stakes exams.
CONCLUSION
This study highlights the need to evaluate study habits using strategies
supported by causal evidence rather than inconsistent correlational data.
Comparing practice questions alone to combinations with content review or
retrieval practice identified approaches that optimize efficiency and
retention. From informal discussions with current students, we learned to
balance intervention intensity with workload and to clearly communicate
relevance during recruitment. Analyses clarified whether supplemental
strategies provide measurable benefits, informing recommendations for
students and educators seeking improved performance.