A pathology residency curriculum built around retrieval practice held up at five years

Five years of spaced testing in a two-year pathology core curriculum tracked rising practice scores and faster in-service gains for UK residents.

Contents

In one sentence

A two-year pathology residency curriculum that put retrieval practice at the centre showed rising practice scores and, for United Kingdom residents, faster annual gains on in-service exams — with strong trainee buy-in five years on.


What the researchers did

Nebbache and colleagues designed a Pathology Core Curriculum for anatomic and clinical pathology residents after reviewing adult-learning evidence. The programme ran over two years and deployed six adult-learning principles, with periodic testing — recall, application, and consolidation — as the main strategy rather than passive lectures alone.

They tracked retrieval-practice scores over time and how those scores related to resident in-service exam results, especially in surgical pathology (which dominated the practice questions). For residents in the United Kingdom they compared year-on-year in-service improvement after the curriculum started with the pre-curriculum trend and with national gains per year. An anonymized survey of residents and graduates asked whether the curriculum supported learning and practice competency. This write-up summarises their five-year critique; it is not a multi-site randomised trial.


What they found

  • Retrieval-practice scores showed a significant upward trend after the curriculum launched.
  • Practice scores correlated most strongly with surgical pathology in-service exam scores — consistent with how many practice items covered that area.
  • For UK residents, annual in-service improvement post-curriculum outpaced the pre-curriculum rate in eight of ten disciplines.
  • The same cohort’s yearly gains beat national gains/year in five of ten disciplines.
  • Most surveyed residents agreed or strongly agreed the curriculum promoted effective learning; most graduates agreed it helped practice competency.

What this means for learners and educators

  • Residency programmes can treat scheduled retrieval as infrastructure — not an optional quiz night — if the goal is durable access to knowledge under exam and clinical pressure.
  • Align practice-item mix with the domains you care about most: here, surgical pathology dominance showed up in the strongest exam correlation.
  • Spaced testing plus other adult-learning design choices can stay popular with trainees when the routine feels fair and tied to real work, not busywork.
  • Outside pathology, the transferable idea is a core calendar of recall across years, not a one-off workshop — then watch whether local and national score trends move together.

Limitations and what we don't know yet

This is a single-programme, observational critique with survey self-report — not a randomised comparison against an alternate curriculum. Abstract-level reporting does not give exact sample sizes, effect sizes, or how much of the gain came from retrieval practice versus the other five principles. UK in-service trends may not generalise to other countries’ exams. Selection, concurrent reforms, and exam drift can all inflate apparent gains. We also lack detail on spacing schedules and item quality — the ingredients that usually make or break retrieval programmes.