Knowledge Retention: 7 Proven Strategies for Healthcare Educators
Published: 16 January 2019
Knowledge retention, or knowledge management, is the process by which new information is transferred from the short-term to long-term memory. Yet, because human memory is imperfect there is a constant need for educators to find effective, creative teaching strategies to support the long-term preservation of knowledge in their students.
This isn’t just a problem for new learners, as Lindsey et al. (2014) point out, students at every educational level are challenged by ever increasing amounts of material to review and master.
Why Can Knowledge Retention Be So Difficult?
To put it simply, the human brain is wired to forget. Information that isn’t quickly linked to other well-established concepts tends to make far fewer connections in the brain and can be easily forgotten (Goins and Fisher 2018).
Without positive reinforcement, research shows that after 30 days only 10 per cent of the learning acquired in a passive state is retained, simply because learners don’t apply what they’ve learned.
70 % of a learner’s knowledge comes from on the job training;
20% from interacting with peers; and
10% from formal education and training.
(The Ivey Academy 2017)
This means that if knowledge retention is to be effective it is essential to help learners find creative ways to form links with prior learning and put what they have learned into practice as soon as possible.
So how can educators make the process of knowledge retention as easy as possible?
Studies conducted by the Education Corner (2018), show that working with a variety of teaching methods and materials can go a long way to improving retention and recall of information.
The following teaching methods have proved particularly useful in supporting knowledge retention.
Simulation training is a well-known strategy to help embed previously taught skills and allow students to blend their skills together in realistic simulations.
Studies performed by Cecilio-Fernandes et al. (2018) have also shown that adding simulation training prior to clinical placement helps improve the acquisition and retention of a student’s knowledge. Moazed, et al. (2013) endorses these findings, suggesting that simulation-based learning is also a highly efficient and effective model of teaching.
Studies on problem-based learning also support the effectiveness of simulation training as a way to relate learning objectives to real world situations (Beers and Bowden 2015). Using problem based learning also gives learners a safe and effective way of appreciating the benefits, or consequences, of their actions in a safe, risk free learning environment.
Scenario-based e-learning can also improve engagement and deepen understanding by motivating learners to analyse situations before making decisions (Badiei et al. 2016).
The more closely the learning environment can be matched to real life clinical environments the better knowledge retention will be. However, when this is not possible learners should be helped to visualise successfully performing the task with audio and visual aids that reflect real life situations.
Simple ways that this can be achieved include:
Using audio and video material, as well as elements such as taste, touch or smell, when possible;
Matching the learning environment to the working environment; and
Helping learners visualise successfully performing the task.
(Goins and Fisher 2018)
The brain is designed to prioritise every new piece of information it receives. Firstly, for safety and survival, secondly for emotion, and thirdly for meaning.
It’s long been known that emotional messages last far longer in the memory than purely factual information. Given this, adding emotional content can help information stay in the learners’ mind long after the teaching session is over.
For example, storytelling can take the form of:
Patient case histories;
Using evocative images or videos; and
Quoting patient testimonies that evoke an emotional response in the learner.
Viewing the learner as a passive recipient of knowledge goes against almost all of what we know about knowledge retention. This is why active participation in teaching sessions is so important. Active learning increases engagement and leads to much better retention of new knowledge.
Active participation can be encouraged by:
Practice sessions and simulations;
Breakout sessions for teamwork; and
(Goins and Fisher 2018)
Bite Sized Learning
A well-known cause of poor knowledge retention is simply having too much information to absorb all at once. This can happen when, for example, teaching sessions are too long or contain too much content. By breaking the material down into smaller manageable chunks of learning, knowledge is far more likely to be retained and remembered (Education Corner 2018).
Short, frequent teaching sessions are known to result in much better recall of information, compared to a single long lecture.
According to the results of a study conducted by Badiei et al. (2016), electronic learning enables greater retention of knowledge than simply learning from books (read - Using Technology to Engage Nurses in Continuing Education). This, they suggest is because e-learning is based on constructivism in which knowledge is not simply transferred from an educator to a learner but is learned through the creation of associations between existing knowledge and new information.
Repetition and Recall is Key to Knowledge Retention
Another simple way to boost learning retention is through simple, old-fashioned repetition and recall. Repeating new knowledge or tasks is key to the process of moving information from the learner’s short to long-term memory.
One of the simplest knowledge retention techniques is the use of quizzes, tests, or group feedback sessions (read - How to Give Effective Feedback: 6 Tips for Nurse Educators). Assessing knowledge based on a narrow range of learning objectives can also help learners to focus in on bite-sized chunks of information and keep track of their own progress. It also provides trainers with useful information about the effectiveness of their teaching methods.
Encouraging critical thinking skills (read - Cultivating Critical Thinking in Healthcare) is another teaching strategy that has been shown to increase knowledge retention rates over time. This is because it encourages an active state of learning, which itself leads to greater engagement.
Ultimately, the key to ensuring good learning retention is to make use of the way in which the adult brain absorbs, holds and processes information. Strategies to enhance recall include:
Using clear learning objectives;
Keeping learning sessions short;
Making explicit links between what is being taught and real-life situations; and
Encouraging trainees to use their knowledge as soon as possible.
(Education Corner 2018)
Despite its importance, retention of knowledge and skills has rarely been studied. That said, research has shown that dynamic teaching methods accompanied by colours, illustrations, and animation can go a long way to enhance both understanding and knowledge retention in the learner. Ultimately, any training method that can enhance knowledge retention will have measurable benefits in terms of patient care, and that has to be worthwhile.
Badiei, M., Gharib, M., Zolfaghari, M. et al. (2016) 'Comparing nurses' knowledge retention following electronic continuous education and educational booklet: a controlled trial study', Medical Journal of Islamic Republic of Iran. , 30(), pp. 364 [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972056/ (Accessed: 16.12.18).
Beers, G.W. and Bowden, S. (2005) 'The effect of teaching method on long-term knowledge retention', Journal of Nursing Education 44(11):511-4 , 44(11), pp. 511-4 [Online]. Available at: https://www.researchgate.net/publication/7426695_The_effect_of_teaching_method_on_long-term_knowledge_retention (Accessed: 16.12.18)
Cecilio-Fernandes D., Brandão CFS., de Oliveira DLC. et al. (2018) 'Additional simulation training: does it affect students’ knowledge acquisition and retention?', BMJ Simulation and Technology Enhanced Learning , (), pp. [Online]. Available at: https://stel.bmj.com/content/early/2018/06/22/bmjstel-2018-000312 (Accessed: 16.12.18).
Education Corner (2018) The Learning Pyramid, Available at: https://www.educationcorner.com/the-learning-pyramid.html (Accessed: 16.12.18).
Goins, T. and Fisher, J. (2018) Knowledge Retention Tactics For More Effective Learning, Available at: https://trainingindustry.com/articles/content-development/knowledge-retention-tactics-for-more-effective-learning/ (Accessed: 16.12.18).
Lindsey, R.V., Shroyer, J.D. Pashler, H. et al. (2014) ' Improving Students’ Long-Term Knowledge Retention Through Personalized Review', Psychological Science, 25(3), pp. [Online]. Available at: https://journals.sagepub.com/doi/abs/10.1177/0956797613504302(Accessed: 16.12.18).
Moazed, F., Cohen, E.R., Furiasse, N. et al. (2013) 'Retention of Critical Care Skills After Simulation-Based Mastery Learning', Journal of Graduate Medical Education, 5(3), pp. [Online]. Available at: http://www.jgme.org/doi/full/10.4300/JGME-D-13-00033.1(Accessed: 16.12.18).
The Ivey Academy (2017) A teaching method to ensure maximum learning retention, Available at: https://www.ivey.uwo.ca/academy/learning-centre/2017/11/a-teaching-method-to-ensure-maximum-learning-retention/ (Accessed: 16.12.18).
Anne is a freelance lecturer and medical writer at Mind Body Ink. She is a former midwife and nurse teacher with over 25 years’ experience working in the fields of healthcare, stress management and medical hypnosis. Her background includes working as a hospital midwife, Critical Care nurse, lecturer in Neonatal Intensive Care, and as a Clinical Nurse Specialist for a company making life support equipment. Anne has also studied many forms of complementary medicine and has extensive experience in the field of clinical hypnosis. She has a special interest in integrating complementary medicine into conventional healthcare settings and is currently an Associate Tutor, lecturing in Health Coaching and Medical Hypnosis at Exeter University in the UK. As a former Midwife, Anne has a natural passion for writing about fertility, pregnancy, birthing and baby care. Her recent publications include The Health Factor, Coach Yourself To Better Health and Positive Thinking For Kids. You can read more about her work at www.MindBodyInk.com. See Educator Profile