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Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency. We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine certification examination. Method: We conducted a cluster randomized controlled trial to empirically and pragmatically test spaced education using two versions of the Family Medicine Study Guide mobile app. 12 residency training programs in Canada agreed to participate. At six intervention sites, we consented 335 of the 654 (51%) eligible residents. Residents in the intervention group were sent alerts through the app to encourage the answering of questions linked to clinical cases. At six control sites, 299 of 586 (51%) residents consented. Residents in the control group received the same app but with no alerts. Incidence rates of case completion between trial arms were compared using repeated measures analysis. We linked residents in both trial arms to their knowledge scores on the certification examination of the College of Family Physicians of Canada. Results: Over 67 weeks, there was no statistically significant difference in the completion of clinical cases by participants. The difference in mean exam scores and the associated confidence interval did not exceed the pre-defined limit of 4 percentage points. Conclusion: Further research is recommended before deploying spaced educational interventions in the Family Medicine residency to improve knowledge.

The WHO endorses family medicine (FM) globally to improve health outcomes. The Besrour Centre (BC) brings together partners from low- and middle-income countries (LMICs) to collaborate on FM development in different contexts. Faculty development is an identified area of need, but specific needs were unknown. A qualitative study was conducted using two 1-1.5-hour focus groups at the 2015 BC conference. Ten countries and 12 universities were represented. Transcripts from semi-structured interviews were analysed for themes using a descriptive approach. There was unanimous support for the need for faculty development tools and resources, particularly in teaching skills. Most programmes lacked formal structure or funding. A consistently identified concept was how to teach specialist faculty the FM context, as was the importance of FM perspective to inform government policies. The need for faculty development of FM in LMICs is strong. FM faculty development resources can be expanded and shared through global health networks. Further expansion of faculty development workshops and toolkits is recommended. This study adds to the current knowledge because it helps to identify the gaps and priorities, specifically focused on LMICs, when developing faculty development FM programmes.

We examined the influence of encoding duration in high- and low-anxious undergraduates on memory accuracy and confidence. Participants encoded words for 750 or 4,000 ms, and later made recognition and confidence judgments in their memory for targets and lures. The high-anxious had poorer memory accuracy than the low-anxious group, and endorsed lower confidence specifically for correct memory responses. There was no differential effect of encoding time across groups, though longer encoding time benefited both accuracy and confidence. As accuracy increased so did confidence in the low-anxious group, indicating higher resolution and Gamma correlations for meta-memory judgments, though this was not the case for high-anxious individuals. Results indicate that people with high levels of anxiety have unrealistically low confidence in their memories as their confidence was a poor predictor of accuracy and allowing additional encoding time does not alleviate this effect.

Background: The benefits of “spaced education” have been documented for residents in highly focused specialties. We found no published studies of spaced education in family medicine. In this study, we report on the feasibility of delivering weekly alerts from a mobile application (app) developed for exam preparation, to increase the reading of clinical information in the family medicine residency. Methods Design: This is a 2-phase mixed methods study. Phase one is a quasi-experimental study of resident reading of information related to priority topics in family medicine. Reading was documented by page views in a noncommercial mobile app. Participants: All incoming first-year residents at two university training programs in Canada. The intervention group received one alert per week to priority topics on the app, beginning in their second month of residency. The control group was given access to the same app, but received no alerts. Results: In this paper, we report the phase one preliminary findings. In the intervention group, 81 of 96 first year residents consented. At the control site, 79 of 85 residents consented. After 100 days, intervention group residents had viewed more pages of clinical information across all 99 priority topics (1,546 versus 900) and per topic (15.7 versus 9.1 pages, P < 0.0003). On average, each increase of one visit to the app following a weekly alert was associated with an increase of 3.2 visits to pages of clinical information in the app. Conclusion: A weekly alert delivered via mobile app shows promise with respect to reading in the family medicine residency.