The Effects of Retrieval Practice on Knowledge Acquisition and Durable Learning in Undergraduate Nursing Students

Recent reports of unpreparedness and failure to rescue incidents among new graduate nurses are concerning for nurse educators and health care. New graduates must retrieve and apply learned knowledge to make sound clinical decisions, emphasizing the need for durable learning and knowledge acquisition. Durable learning, which involves understanding and recalling learned information days, weeks, or months later is crucial for clinical judgment. Nurse educators should facilitate durable learning through effective, evidence-based learning techniques such as retrieval practice (RP), which has shown promise in health professions education but is underutilized in nursing education. This study explored the impact of RP on acquisition and durability of nursing specific knowledge. The purpose of this study was to determine if prelicensure undergraduate students using retrieval practice strategies in a nursing course would demonstrate improved knowledge acquisition and durable learning after an RP intervention. The research questions were: Q1 For senior-level, third semester prelicensure students in a Nursing with Diverse Populations course, is there a statistically significant difference in exam scores (knowledge acquisition) of students participating in a retrieval practice intervention compared to those who do not? Q2 For senior-level, third semester prelicensure students in a Nursing with Diverse Populations course who participate in a retrieval practice intervention, is there a statistically significant difference in exam scores at the end of the semester (durable learning) eight weeks following participation compared to those who do not? Q3 For senior-level, third semester prelicensure students in a Nursing with Diverse Populations course who participate in a retrieval practice intervention, what is the relationship between the types of retrieval practice strategies used for exam preparation and subsequent exam scores? Q4 For senior-level, third semester prelicensure students in a Nursing with Diverse Populations course who participate in a retrieval practice intervention, what is the relationship between frequency of retrieval practice strategies used for exam preparation and subsequent exam scores? A quasi-experimental pretest-posttest design was used. Differences in the course exam scores of intervention participants and non-participants measured knowledge acquisition and durable learning. The intervention included two sessions where participants practiced RP strategies with faculty facilitation and then used them for exam preparation. The theoretical framework was Miller’s (1956) cognitive information processing theory, which was further developed by Atkinson and Shiffrin (1968). Eighty-three undergraduate nursing students participated, self-selecting into the intervention group (n=40) or participation group (n=43). Exam scores were obtained before the intervention, after the intervention, five weeks later, and at semester-end. Intervention participants completed a survey on RP strategies used. No statistically significant differences were found between groups, within groups, or over time when data was analyzed using paired t-tests, repeated measures ANOVA, and linear mixed effects model. Despite this, RP strategies were widely adopted, highlighting their value to students. Survey results showed 100% of participants used at least one RP strategy. The most-used strategy was quizzing aloud with a partner (92%), followed by free recall (79%) and closed-book self-quizzing (74%). The least-used strategy was the read-test-read-test pattern (25%). This study contributed to nursing education research by documenting RP strategies used in an undergraduate nursing course. Results revealed nursing students readily employed RP strategies, suggesting their potential in nursing education.