Does the Use of Pre‐made Digital Flashcards Aid in Medical Students Learning of Anatomy
Authors: Loving Robert J. , Haeussler Caleb , McMurray John R. , Peacock Brianna , Hsu Mitchell , Day Leslie 
Published: May 2022

Objective

The transition from undergraduate education to undergraduate medical education is often difficult for first year medical students (MS1s) and often requires new study techniques. Spaced repetition has shown to be an effective learning method that can be achieved utilizing flashcards. While pre‐made 3rd party flashcards efficiently teach large amounts of information, discrepancies and gaps in content exist. Alternatively, making personalized cards can be time intensive. This study explored the effect of neer‐peer created flashcards on MS1s anxiety levels, metacognitive awareness and classroom performance during a Medical Gross Anatomy course.

Materials and Methods

The five second‐year medical students (MS2s) prepared digital flashcards using Anki, a widely used digital flashcard application based on spaced repetition. The Anki cards mirrored the faculty provided materials and included pictures of anatomical structures and the facts that were judged to be most important for understanding and comprehension.

The Anki cards were provided to 48 MS1s enrolled in a Medical Gross Anatomy course at an engineering‐medicine allopathic medical school. To test the benefits of Anki cards, the students were given an optional survey at the end of the course.

Surveys contained a copy of the Westside Test Anxiety Score (WTAS) and Anki card usage. WTAS is a 10 question survey to screen for anxiety impairments that may impact a student's test performance. For statistical analysis, the surveys grouped the students generally as, not using Anki at all, using MS2 Anki cards, and using 3rd party Anki cards.

Results

Out of the 48 MS1s who were sent the survey, 25 students responded to the survey. When asked to rate their opinion of the cards on a scale of 1‐5 (1=”not helpful”, 5=”very helpful”) 82% rated them at least a 3 and 40% rated the cards as a 5/5. 71% of students who used third party Anki cards found them “not helpful”. 52% of students who made their own cards found them “not helpful).

Students who used 3rd party Anki cards exhibited greater test anxiety, with an average score of 3.88 on the WTAS (classified as “High Test Anxiety”), compared to students who did not use 3rd party cards, average score of 2.77 (classified as “Normal‐high test anxiety”) (t‐test, p <0.05). There was no statistically significant difference in test anxiety between students who used the MS2’s premade deck versus students who did not (t‐test,2.52 vs 3.05, p=.25).

Conclusion

This study was aiming to determine if any benefits exist in providing MS1s with premade Anki cards based off of their medical school’s curriculum. Almost all (80%) of survey respondents found the MS2‐made Anki cards helpful in their studies. This is likely due to the confidence that the flashcards were made based on their school’s curriculum and were made by students who had previously completed the course. This is supported by the observation that students who used 3rd party decks had higher test anxiety than those who did not. This may be due to the fact that 3rd party flashcards do not align well with an individual medical school’s curriculum, resulting in students feeling unsure if they are studying the right material for their exams.

Limitations included a small sample size and low survey response rate, especially for students who did not use anki.