Evaluating Knowledge Retention Over Time: A Comparative Study of Online Versus In-Person Medical Education

The COVID-19 pandemic caused a rapid shift from traditional face-to-face education to online learning, significantly impacting medical education, particularly anatomy courses. Although online learning provides flexibility and accessibility, its effect on long-term knowledge retention remains unclear. This study investigated the differences in neuroanatomy knowledge retention over time between online and in-person learning environments within the same student cohort. A total of 108 medical students who initially completed an online neuroanatomy course and exam in their second year were reassessed three years later during their fifth-year clinical internship using the same test administered in person. Descriptive statistics, paired t-tests, chi-square tests, and one-way ANOVA were used to analyze performance changes. Independent t-tests and Welch’s t-tests were used to evaluate the effects of gender, age, and question type on knowledge retention. Student performance significantly declined over time, with mean scores decreasing from 65.72% (SD = 14.92) to 51.62% (SD = 15.57) (t = 9.019, p < 0.001). No significant differences were observed between male and female students (p = 0.726) or among the different age groups (p > 0.05). Analysis by question type revealed the highest retention for short questions (72% accuracy), whereas open-ended question showed the poorest performance, with no correct responses recorded. A substantial decrease in neuroanatomy knowledge retention was observed over time, independent of sex and age. These findings highlight the importance of implementing educational strategies, such as regular review sessions and reinforcement activities, to support long-term retention. Curriculum improvements should focus on fostering conceptual understanding and addressing content areas with the greatest knowledge loss.