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An analy ic s udy o knowledge e en ion a di e en ime in e als
among junio esiden s ollowing ecapi ula ion o p esen ed slides
silen ly a he end o eaching session
Suman Cha opadhyay1*
1Depa men o Anaes hesiology, Midnapo e Medical College, Midnapo e, Wes Bengal, India.
A icle in o Abs ac
In oduc ion
Knowledge e en ion a e a eaching session is an
impo an e e ence. Gene ally, acili a o s p esen using
Powe Poin slides, in e ac wi h he audience, and
discuss c i ical ake-home messages a he end o a
eaching-lea ning session. Knowledge e en ion is
usually checked a In e nal Assessmen (IA). The cu en
s udy looked in o an unknown ace o medical
educa ion—whe he ecapi ula ion o Powe Poin slides
a he end o a eaching session helps in sho —and
in e media e- e m knowledge e en ion by s uden s.
Powe Poin slides a e p e e ed o mos knowledge-
based eaching-lea ning sessions [1, 2]. To be e ec i e
as a lea ning ool, he p esen a ion slides should be clea ,
concise, o he poin , w i en, and consis en h oughou
he design, ega ding on , spacing, and ma gin [3]. The
limi o lines in a Powe Poin slide is gene ally six, wi h
no mo e han six elemen s pe slide, and designed isuals
o make he slide eadable wi hin one minu e [2]. As ou
s udy ocussed on he e ec o Powe Poin slide
ecapi ula ion, he slides we e p epa ed as pe guidelines.
S uden s lea ning ac ual knowledge should be assessed
by ac i ely ecalling in o ma ion and e es ing a
expanding ime in e als o make lea ning mo e e ec i e
and ensu e op imal long- e m e en ion o knowledge [4].
E ec i e e ie al p ac ice depends on he deg ee o
which he ye - o-be-lea ned in o ma ion is ulne able o
Cha opadhyay. J Med Edu De . 2025; 18(1): 123-131 Jou nal o Medical Educa ion De elopmen
Backg ound & Objec i e: Facili a o s commonly ponde how o e ec i ely conclude a
lea ning session, and he e a e no clea answe s. This no el s udy analyzes he impac o silen
ecapi ula ion o p esen ed slides a session end on immedia e and sho - e m knowledge
e en ion among Junio Residen s (JR) es ed a di e en ime in e als.
Ma e ials & Me hods: This single-cen e , p ospec i e, non- andomized in e en ional s udy
was conduc ed a Midnapo e Medical College in India. Fi een pos g adua e JR o
Anaes hesiology a ended 14 knowledge-based eaching sessions, while 22 JR pa icipa ed in
he subsequen 14 sessions. Teaching sessions we e alloca ed in a sequen ial, non- andomized
manne , wi h 50% o sessions ending wi h a silen ecapi ula ion o Powe Poin slides ollowing
Take-Home Messages (THM) (S udy g oup, n = 14 sessions), while he o he 50% o sessions
ended wi h a discussion o THM only (Con ol g oup, n = 14 sessions). All pa icipa ing JRs
we e assessed wi h i e di e en Mul iple Choice Ques ions (MCQs) each on he i s and
se en h day a e sessions and again a In e nal Assessmen (IA) a e 2 mon hs. Da a analysis
was pe o med using pai ed - es s o wi hin-g oup compa isons, unpai ed wo- ailed - es s,
and ANOVA es s o be ween-g oup compa isons.
Resul s: The MCQ sco es on day 1 we e signi ican ly highe in he s udy g oup compa ed o
he con ol g oup (82.0 s. 65.2, p < 0.00). Howe e , mean MCQ sco es on day 7 in bo h g oups
we e signi ican ly di e en om day 1 MCQ sco es bu simila o each o he (71.2 and 73.5, p
= 0.29). The sco es a IA imp o ed om day 7 MCQ sco es in bo h he s udy g oup (71.2 s.
82.0, p < 0.05) and he con ol g oup (73.5 s. 83.2, p < 0.05).
Conclusion: Fo JRs, he e is signi ican sho - e m e en ion o knowledge a e a silen
ecapi ula ion o slides a he end o a session compa ed o he con ol g oup.
Keywo ds: Junio esiden , slide p esen a ion, mul iple-choice ques ions, knowledge e en ion,
eaching s a egies
*Co esponding au ho :
Suman Cha opadhyay. An analy ic
s udy o knowledge e en ion a
di e en ime in e als among junio
esiden s ollowing ecapi ula ion o
p esen ed slides silen ly a he end o
eaching session
Email: [email protected]
O iginal A icle
A icle his o y:
Recei ed 30 Ma . 2024
Accep ed 27 Jan. 2025
Published 14 Ap . 2025
How o ci e his a icle:
Cha opadhyay S. An analy ic s udy
o knowledge e en ion a di e en
ime in e als among junio esiden s
ollowing ecapi ula ion o p esen ed
slides silen ly a he end o eaching
session. J Med Edu De . 2025; 18(1):
123-131.
[ DOI: 10.61186/edcj.18.1.123 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ]
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Cha opadhyay: E ec o end session silen ecapi ula ion o slides
124 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025
o ge ing [3, 4]. Spacing epe i ion wi h a ecall o
ac ual knowledge by es ing ele an knowledge con en
is bene icial when he lea ning con en consis s o
ac i i ies ha in e e e wi h lea ning (like du ies, o he
classes on di e en opics, and so on) [5]. E alua ing
pos g adua e s uden s a e a class based only on
o ma i e assessmen is challenging, as i depends on
indi idual pe spec i es [6]. To each ou o s uden s, i is
impo an o ei e a e he impo an Take-Home
Messages (THM) om he session [7]. This is gene ally
done e bally by acili a o s a he end o he discussion,
wi h mos summa izing he THM o he session.
Howe e , e bal discussion akes ime, and a he end o
class, he ocus o mos s uden s o en needs o be
imp o ed. 'Ou eyes can ead as e han ou mou h can
ell' [8]. The basic concep o his s udy is ha going
h ough he slides again wi hou ocaliza ion a he end
o class will imp o e s uden 's g asp o concep s wi hou
u he loading an o e bu dened audi o y inpu . This
s udy es ed whe he discussing THM wi h silen
ecapi ula ion is supe io o discussing only THM by
assessing es sco es la e a p e- ixed in e als.
Online quizzes used pe iodically a e highly bene icial
ools o lea ning because hey compel s uden s o wo k
pe sis en ly wi h o he ongoing class ac i i ies [9]. Quiz-
based lea ning is mo e engaging and in e ac i e while
inc easing cu iosi y, hus p opelling ad anced lea ne s
owa d sel -di ec ed lea ning [10]. Google Fo ms wi h
Quiz has p o en o be an e ec i e ool o lea ning and
assessmen [11]. Mul iple-Choice Ques ions (MCQs)
can be used jus as well as Open-Ended Ques ions
(OEQs) o assess he applica ion o knowledge, and a
high co ela ion exis s be ween MCQs and OEQs when
bo h a e ac -based [12]. Sho Answe Ques ions (SAQ)
a e commonly used as open-ended ques ions. The use o
es s o knowledge enhancemen equi es ha hey be
gi en ela i ely soon a e lea ning exe cises and de i ed
speci ically om he in o ma ion lea ned [13]. Some
au ho s ha e ound Ex ended Mul iple Choice Ques ions
(EMCQs) well sui ed o clinical easoning in esiden s
[14]. Fo his s udy, we used MCQ sco es one day and
one week a e sessions, while SAQs we e used o he
i s IA and EMCQs o he second IA. Mo e s udies need
o be conduc ed o compa e hese wo IA echniques.
The Na ional Medical Commission (NMC) in India has
s ipula ed ha p esen a ion should no exceed one- hi d
o he allo ed ime, while he es o he ime is o
in e ac ions and o ma i e eedback. In pos g adua e
cu icula, IA should be held a leas once e e y h ee
mon hs [15]. Based on hese guidelines, he class
schedule and IA we e planned o his p ospec i e s udy.
E en hough we a e mo e accus omed o la ge o small
g oup eaching sessions by name, he cu en
classi ica ion includes medium-sized g oups o 15 o 34
lea ne s [16]. This is ypical o a pos g adua e
depa men 's o al Junio Residen (JR) s eng h. In ou
depa men , he e we e 15 o 22 pa icipa ing JRs a he
ime o his s udy, hus con o ming o he ypical
classi ica ion o a medium-sized g oup. When o pe o m
es ing is an ongoing ques ion, as spacing be ween es s
is impo an o knowledge e ie al. Tes s conduc ed on
days 1, 7, and 2 mon hs a e adequa ely spaced es ing
in e als and ha e been used in ea lie s udies [14].
This s udy compa es he impac o silen ecapi ula ion
o Powe Poin slides a he end o eaching sessions a e
discussion o THM by assessing knowledge
ecapi ula ion using MCQ quizzes one day and one week
a e he eaching session and SAQ and EMCQ a IA held
wo mon hs a e he s a o each session. This is done
by compa ing hese sessions wi h sessions allo ed o end
wi h ake-home messages only. To ou knowledge, no
p e ious s udy has analyzed his in e en ion o silen
ecapi ula ion o slides and spaced in e al es ing,
compa ing i s e icacy o he home messages alone.
The s udy hypo hesis was ha he e would be no
di e ence in he pe o mance o s uden s ega ding he
in e en ion o silen ecapi ula ion o slides a he end o
he g oup eaching session compa ed o o he sessions
wi hou slide ecapi ula ion when es ing sco es on day 1
and day 7 a e he eaching session and also a in e nal
assessmen (null hypo hesis). The al e na e hypo hesis
was he e would be a signi ican di e ence be ween he
g oups a di e en e alua ion imes.
Ma e ials & Me hods
Design and se ing(s)
This p ospec i e, non- andomized, in e en ional (quasi-
expe imen al) ial o wo class oom-based medical
educa ion echniques was conduc ed a he pos g adua e
depa men o Anaes hesiology and C i ical Ca e,
Midnapo e Medical College, in he s a e o Wes Bengal,
India, om Oc obe 2023 o Janua y 2024, a o al o ou
mon hs a e app o al om he Ins i u ional E hics
Commi ee (IEC) and w i en in o med consen om all
JRs.
Pa icipan s and sampling
All pos g adua e JR o he Depa men o
Anaes hesiology o a e ia y ca e go e nmen medical
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Volume 17 ¦ Issue 54¦ 2024
college in eas e n India who a ended all medium-sized
g oup knowledge-based sessions wi h Powe Poin
p esen a ions (s uden semina s, acul y lec u es, case
p esen a ion u o ials, e c.) we e included in he s udy. In
he i s hal o his s udy, ill he i s IA, 15 JR o he
second and inal yea we e included as i s -yea JRs had
jus joined. In he second hal o he s udy, all 22 JR
pa icipa ed. This included se en consen ing i s -yea
JRs. We used pu posi e sampling o include all eligible
and willing JRs in his s udy. Exclusion c i e ia o his
s udy we e pa icipan s a ending hose sessions no
using Powe Poin slides o THM o bo h and hose
pa icipan s who declined o gi e consen o we e
una ailable du ing es ing. 50% o all knowledge-based
eaching assignmen s ended wi h a silen ecapi ula ion
o p esen ed slides ollowing THM by eache s in ol ed
(S udy g oup; G oup R – Recapi ula ion g oup, n = 14
sessions). The o he 50% o all knowledge-based
eaching assignmen s ended wi h a discussion o THM
only by eache s in ol ed wi h no ecapi ula ion o slides
(Con ol g oup, G oup NR – Non-Recapi ula ion g oup,
n = 14 sessions). All eaching sessions we e alloca ed
al e na ing be ween he wo conclusion echniques, and
all JRs we e allo ed o he wo g oups (R and NR)
al e na ely (1:1 a io)in a sequen ial, non- andomized,
pu posi e manne (Figu e 1).
Tools/Ins umen s
Teaching-lea ning sessions we e ixed a a ound 60
minu es o e ou mon hs a e discussing wi h
s akeholde s (i.e., acul y and JRs). The sessions we e
p e-planned, keeping only one- hi d o he ime o
Powe Poin slide p esen a ions as pe NMC guidelines.
To make his easible, a maximum o 20 Powe Poin
slides wi h six lines, a ound six lines pe slide, we e
allowed pe session, which we e expec ed o ake a mos
20 minu es. The es o he session was used o
in e ac ions, explana ions, eedback, and commen a ies
as equi ed by he eaching acili a o conce ned o
lec u e classes and eache -mode a o in case o
pos g adua e semina s, u o ials, case p esen a ions, e c.
A he end o he p esen a ion, all eaching-lea ning
sessions ended wi h ake-home messages (bo h G oup R
and NR). In g oup R, an addi ional 5 minu es was allo ed
o silen ecapi ula ion o slides. Taking a less- han-
no mal eading speed o 200 wo ds pe minu e o
eading silen ly, 20 slides wi h a maximum o a ound 40
wo ds pe slide can be ead in 4 minu es [8]. Fo p ac ical
pu poses, he las 5 minu es o a eaching session we e
kep o silen ecapi ula ion o slides a a com o able
pace. The JRs we e ins uc ed be o ehand o aise hei
hands indi idually a e ca e ully going h ough he
indi idual p esen ed slide silen ly. When all hands had
gone up, he nex slide was hen p ojec ed. One day a e
he eaching session (day 1), i e MCQs we e placed in
he Depa men al Wha sApp po al a a p e ixed ime
using he link gene a ed om he Google Fo ms quiz
op ion. These ques ions and op ions we e discussed
amongs depa men al eache s a e class by he class
mode a o and we e om he con en s o Powe Poin
slides. The o e all collec i e (g oup) mean MCQ sco e
om Google Fo ms was shown in pe cen age o bo h
he g oups and eco ded session-wise. Exac ly a week
a e eaching (day 7), a sepa a e se o i e impo an
MCQs om he same augh opic we e pu up using he
quiz op ion o Google Fo ms. These ques ions we e
again ag eed upon amongs depa men al eache s and
we e om he con en o he Powe Poin slides bu
di e en om p e iously asked ques ions. The o e all
collec i e mean MCQ sco e om Google Fo ms was
calcula ed using pe cen ages. As be o e, assessmen
sco es we e no ed and compa ed in bo h g oups. Real-
ime sco es we e sha ed wi h pa icipan s on day 1 and
day 7 a e he quiz wi h eedback on co ec esponses
o indi idual quiz ques ions p o ided in Google Fo ms,
which was se such ha all ques ions we e o be answe ed
manda o ily and he co ec answe made known o
esponden s only a e answe ing. The p esen e sha ed
he Powe Poin slides wi h all JR h ough he Wha sApp
g oup only a e he day 7 quiz was conduc ed. As
ei e a ed abo e, he g oups we e decided on he
me hodology o class conclusion o g oups R and NR,
espec i ely. All a ailable JRs a ended he classes and
he assessmen sessions. The o al numbe o eaching
sessions was 28. Hal o all eaching assignmen s ended
wi h silen ecapi ula ion o Powe Poin slides ollowing
THM by eache s in ol ed (G oup R, n =14), while he
o he 50% o all knowledge-based eaching assignmen s
ended wi h discussion o THM only by eache s in ol ed
wi h no ecapi ula ion o slides (G oup NR, n =14).
IA examina ions we e conduc ed a 2-mon h in e als
based on ques ions om eaching sessions o bo h
g oups, and G oupWise esul s we e compa ed. In he
i s IA (IA 1), mul iple open-ended SAQs om each
opic we e gi en, and he assessmen was done in he
depa men al semina oom. This was pe o med a e
se en sessions om g oups R and NR we e comple ed, a
o al o 14 sessions. The JRs hemsel es assessed he
answe sc ip s o pee s based on a p emade ub ic
sys em. The second IA (IA 2) used a ma ching- ype
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126 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025
EMCQ op ion o Google Fo ms online. This was
pe o med a e 14 sessions, se en om g oups R and
NR, we e comple ed. These sessions we e comple ely
di e en om hose unde he pu iew o IA 1. The
composi e sco es acqui ed in IAs (IA 1 and IA 2) we e
also compa ed. As he s udy concluded a he second IA,
we o mula ed he Google Fo ms o he second IA o
con ain some in o mal ques ions ega ding whe he he
JRs would like o con inue wi h slide ecapi ula ion and
in e im es ing in he u u e, hei choice o assessmen
modali y among he h ee op ions (MCQ, EMCQ, and
SAQ), and he p e e ed in e al o es ing. The s udy
me hodology is de ailed in Figu e 1.
ENROLEMENT
Sequen ial al e na e ALLOCATION o i s 14 eaching sessions
Sequen ial al e na e ALLOCATION o nex 14 eaching sessions
Figu e 1. Flow cha o s udy o sequen ial allo men and assessmen o anaes hesiology JRs
FOLLOW UP AND ANALYSIS
A. Ini ial s akeholde ’s mee ings and p epa ing class schedule
NR me hod o
class conclusion
(n=7)
MCQ assessmen a day 1 and day 7
a e session based on opic
R me hod o
class conclusion
(n=7)
MCQ assessmen a day 1 and day 7
a e session based on opic
IA 1 conduc ed a wo mon hs based on 14 Sessions using SAQs
Same me hodology goes on o nex 14 sessions ill IA 2 conduc ed a mon h 4 using EMCQs
Final S a is ical Analysis
B. In o med consen o Anaes hesiology JR o a end all classes and si o all assessmen s
Sequen ial allo men o
15 senio JR o bo h
class conclusion
echniques
Sequen ial allo men o
22 JR o bo h class
conclusion echnique ill
IA 2 as ea lie
No loss o ollow up and analysis
NR me hod o
class conclusion
(n=7)
MCQ assessmen a day 1 and day 7
a e session based on opic
R me hod o class
conclusion (n=7)
MCQ assessmen a day 1 and day 7
a e session based on opic
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Volume 17 ¦ Issue 54¦ 2024
Da a collec ion me hods
The mean g oup sco es ob ained in Google Fo ms
quizzes we e no ed in an Excel sp eadshee agains
opics, keeping sepa a e subheadings o day 1, day 7,
and a IA o bo h g oups. Mean sco es up o one decimal
poin we e eco ded. They we e c osschecked o p ope
en y and cleaned i any abe a ion was ound.
Da a analysis
All es mean sco es we e compa ed, and da a analysis
was pe o med. Apa om in e -g oup compa ison,
in a-g oup compa ison o mean sco es o e ime was
done (i.e., day 1, day 7, and a IA) o bo h g oups R and
NR. The da a was desc ibed as mean, s anda d de ia ion,
95% con idence in e al, and pe cen age as app op ia e.
Pai ed - es was used o in ag oup compa ison, while
unpai ed wo- ailed - es and ANOVA (analysis o
a iance) es s compa ed in e g oup a ia ions. Small
STATA 14 so wa e (S a aCo p LP, 2017 e sion, Texas,
USA) was used o s a is ical analysis, and Excel
so wa e was used o cha p epa a ion. S a is ical
signi icance was aken as a p- alue o less han 0.05%.
Resul s
Mos junio esiden s a ended he day 1 and day 7 MCQs
and wo mon hly IA sessions. Howe e , in some
si ua ions, no all JRs we e able o pa icipa e due o he
eme gency na u e o pa ien ca e in anaes hesiology
(eme gency su ge y going on in he ope a ing oom),
in e ne connec i i y, and medical issues. The lowes
a endance eco ded was 72.7%, and he maximum
a endance was 100% ac oss he sessions. Mos o he
assessmen sessions had an a endance o 80% o mo e.
The o al no. o classes aken was 28. Hal o all eaching
assignmen s ended wi h a silen ecapi ula ion o
Powe Poin slides ollowing THM by eache s in ol ed
(S udy g oup; G oup R, n = 14), while he o he 50% o
all knowledge-based eaching assignmen s ended wi h a
discussion o THM only by eache s in ol ed wi h no
ecapi ula ion o p esen ed slides (Con ol g oup, G oup
NR, n = 14). All eaching sessions we e aken al e na ing
be ween he wo conclusion echniques. All JRs we e
allo ed o he wo g oups (R and NR) al e na ely in a 1:1
a io, a sequen ial, non- andomized pu posi e manne ,
and assessed wi h 5 MCQs each on day 1 and day 7 and
again a IA a e 2 mon hs.
Figu e 2 shows a composi e box whiske plo o all he
sco es ac oss g oups, showing indi idual g oups' mean,
median, and in e qua ile ange alues. R1, R7, and IA
R a e sco es ob ained on day 1, day 7, and IA in g oup
R, while NR1, NR7, and IA NR a e he sco es on day 1,
day 7, and du ing IA in g oup NR, espec i ely. The Y
axis deno es he pe cen age o ma ks ob ained.
Figu e 2. Box-whiske plo ing o he g oup sco es showing mean, median and in e qua ile ange
No e: R1, R7 and IA R a e sco es ob ained a day 1, day 7 and IA in g oup R; NR1, NR7 and IA NR a e he sco es a day 1, day 7 and du ing IA in
g oup NR.
Table 1 shows he mean es sco es, mean + s anda d
de ia ion, and 95% Con idence In e al (CI). In e and
in a-g oup - es s we e pe o med based on he mean
sco es. The e was a signi ican inc ease in mean MCQ
sco es in g oup R compa ed o g oup NR o day 1
sco es. Howe e , he day 7 mean MCQ sco es in bo h
g oups di e ed signi ican ly om he day 1 sco es. The
sco e a he ime o IA imp o ed om he sco e on day 7
in bo h g oups. The e was no signi ican di e ence
be ween he day 7 and IA sco es be ween he g oups.
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128 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025
This end can also be seen in Figu e 2. The e was no
di e ence be ween he sco es o he i s and second
in e nal assessmen s. Table 2 de ails an analysis o he
compa ison be ween he a ious g oups using
app op ia e s a is ical es s o compa e be ween he
g oups using he composi e mean sco es. 21 s uden s ou
o 22 esponded o he in o mal pa o he second
in e nal assessmen con aining eedback abou he
p ojec . All o hem (100%) liked he idea o
summa izing slides. 19 (90.5%) wan ed he in e im
online assessmen o go on, and he a o ed echnique
was he MCQ assessmen o all s uden s compa ed o
SAQ. 12 s uden s wan ed a e age MCQ assessmen
(57.1%), and 9 (42.9%) wan ed ex ended ma ching ype
MCQs. 17 ou o 21 s uden s (81%) op ed o he es o
be aken a e one week o eaching sessions.
Table 1. Sco es eco ded in he g oups a di e en ime in e als
Time o Tes ing
G oup R (n = 14)
G oup NR (n = 14)
Day 1
82.09 + 10.83 (75.80 - 88.34)*,$
65.23 + 13.59 (57.33 - 73.02)*,$, #
Day 7
71.22 + 14.60 (62.82 - 79.64)
73.55 + 7.18(69.44 - 77.73)
IA a 2 mon hs
82.09 + 9.13 (76.74 - 87.30)$
83.61 + 9.02 (78.01 - 88.45)$,#
No e: Independen - es was used o compa e sco es be ween g oups (R and NR). Repea ed-measu es ANOVA was used o analyze
changes ac oss ime poin s wi hin each g oup.
*Indica es a signi ican di e ence be ween R and NR g oups on Day 1 sco es.
$Deno es a signi ican di e ence be ween Day 7 and IA sco es in bo h g oups.
#Indica es a signi ican di e ence be ween Day 1 and IA sco es in he NR g oup.
Abb e ia ions: n, numbe o pa icipan s; ±, s anda d de ia ion; IA, in e al assessmen ; R, esponsi e g oup; NR, non- esponsi e
g oup; ANOVA, analysis o a iance.
Table 2. In e and in a-g oup es s and hei espec i e alues
G oup compa isons
p- alue
Type o - es
Signi icance
R1 s NR1
0.001
Unpai ed - es
Signi ican
R7 s NR7
0.297
Unpai ed - es
No signi ican
IAR s IANR
0.664
Unpai ed - es
No signi ican
R1 s R7
0.017
Pai ed - es
Signi ican
R7 s IAR
0.035
Pai ed - es
Signi ican
NR1 s NR7
0.026
Pai ed - es
Signi ican
NR7 s IANR
0.005
Pai ed - es
Signi ican
R1 s IAR
0.695
Pai ed - es
No signi ican
NR1 s IANR
0.006
Pai ed - es
Signi ican
IA 1 s IA 2
0.992
Unpai ed - es
No signi ican
R1, R7 and IAR
0.024
ANOVA
Signi ican
NR1, NR7 and IANR
0.004
ANOVA
Signi ican
No e: Unpai ed - es was used o compa e sco es be ween g oups (R and NR) a di e en ime poin s. Pai ed - es was used o analyze wi hin-g oup
changes o e ime. One-way ANOVA was applied o compa e mean sco es ac oss h ee ime poin s wi hin each g oup.
Abb e ia ions: R1, day 1 sco e in g oup R; NR1, day 1 sco e in g oup NR; R7, day 7 sco e in g oup R; NR7, day 7 sco e in g oup NR; IAR,
in e al assessmen sco e in g oup R; IANR, in e al assessmen sco e in g oup NR; IA1, i s in e nal assessmen ; IA2, second in e nal assessmen ;
ANOVA, analysis o a iance; P, p obabili y- alue.
Discussion
This s udy aimed o de e mine whe he silen
ecapi ula ion o Powe Poin slides a he end o eaching
sessions enhances knowledge e en ion among junio
esiden s compa ed o sessions wi hou his in e en ion,
es ing MCQ sco es on day 1 and day 7 a e wa d and
in e nal assessmen conduc ed a e 2 mon hs. The e was
a signi ican inc ease in mean sco es in g oup R compa ed
o g oup NR o day 1. Howe e , he mean day 7 sco es
in bo h g oups we e signi ican ly di e en om day 1
sco es and simila o each o he . The sco es a he ime o
in e nal assessmen (IA) imp o ed om day 7 o bo h
g oups. The e was no signi ican di e ence be ween he
day 7 and IA sco es among he g oups. When he a iance
o sco es was assessed o g oup R and g oup NR ac oss
he h ee es ing in e als, i was ound o be signi ican
o bo h g oups. The e was no di e ence be ween he
sco es o he i s and second in e nal assessmen s. All
s uden s wan ed he silen ecapi ula ion o he slides
echnique o con inue in he u u e. 90.5% o JR's wan ed
he in e im online assessmen o go on a e he p ojec ,
and he a o ed echnique was MCQ o e SAQ (100%).
57.1% o JR's wan ed MCQ, and 42.9% wan ed EMCQ
as he p e e ed me hod o pos - es ing assessmen . 81%
op ed o he es o be aken a e one week o eaching
sessions. In ou s udy, he e was a signi ican inc ease in
day 1 MCQ mean sco e when he no el in e en ion o
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Volume 17 ¦ Issue 54¦ 2024
silen ecapi ula ion was inco po a ed wi h Powe Poin
p esen a ions compa ed o sessions no ollowing his
in e en ion. Howe e , his e ec ape ed o by day 7, so
he in e g oup sco es we e insigni ican . Ini ial sco es
imp o ing a e implemen a ion o a medical educa ion
echnique, which ecedes o e ime, is an obse a ion
om p e ious s udies like implemen ing MCQs o
inco po a ing ideos and explana ions in o Powe Poin
p esen a ions o make i in e es ing [17, 18]. The day 7
sco e decline was p obably a ec ed by no sha ing he
slides wi h s uden s ill he day 7 assessmen was
comple e. In ou s udy, he sco es a IA imp o ed
compa ed o day 7 sco es in bo h g oups. In he s udy
g oup, he sco es a IA we e e en compa able o he day
1 sco e o he in e en ion g oup. In he con ol g oup NR,
he sco es g adually imp o ed o e ime. This signi ican
imp o emen in esul s o e ime a summa i e
examina ions has been p o en o esul om epea ed
es ing, which enables lea ning [19]. The MCQs we e
cons uc ed o highligh he co ec esponse and se ed
as eedback. Feedback is c ucial o lea ning om es s as
i enhances he bene i s o es ing by co ec ing e o s and
con i ming co ec esponses [20]. Al hough es ing
imp o es e en ion in he absence o eedback, p o iding
eedback enhances he bene i s o es ing by poin ing ou
e o s and con i ming co ec esponses [21]. Tes s
should be gi en o en and spaced ou in ime o p omo e
be e e en ion o in o ma ion [19-21]. In ou s udy, es s
we e conduc ed on day 1, day 7, and a 2 mon hs, making
i spaced ou and con i ming he concep o es -enhanced
lea ning [14]. A su p ising esul was no di e ence in
mean sco es be ween he i s and second IAs. In he i s
IA, inal and second-yea JRs ook pa , while i s -yea
JRs we e included in he mix o he second IA. P o iding
eedback du ing MCQ, epea ed es ing, and he
a ailabili y o slides p e- es was p obably e ec i e a
enhancing he e en ion o i s -yea JRs i espec i e o
he exis ing knowledge base o senio JRs. Howe e , we
also ook ca e ha only basic classes we e aken a e
i s -yea JRs joined. The i s IA was based on SAQ and
conduc ed in he class oom, while he second was based
on online EMCQ in Google Fo ms. MCQs can be used
jus as well as SAQs o assess he applica ion o
knowledge, and he e a e high co ela ions be ween
MCQs and OEQs, such as SAQs, when hey a e bo h
con en -o ien ed [12]. Simila mean sco es using di e en
echniques mean ha IA could mo e om class oom o
online. This is pa icula ly impo an because o acul y
sho age and a gene al eluc ance o assess [22]. 90.5% o
JRs wan ed he MCQ pos - es s o be con inued. On a
u he que y abou he mode o p e e ed MCQs, 57.1%
o JRs wan ed MCQs, and 42.9% wan ed EMCQs as he
p e e ed me hod o es ing. 81% op ed o he es o be
aken a e one week o eaching sessions. This is also a
con i ma ion o a cu en 2023 s udy in which s uden s
wan o be in ol ed in hei own MCQ es ing [23]. A
sys emic analysis o he implemen a ion o echnology-
based in e en ions obse ed ha o change p o essional
p ac ice, we mus conside he o ganiza ional con ex and
clinical wo kload [24]. We ha e been igo ous in ini ial
planning, implemen a ion o es s, main aining es
s anda ds, p o iding eedback, and sequen ially aking
eaching sessions as pe s udy p o ocol. This was
implemen ed despi e a emendous wo kload, acul y
sho age, and o he hind ances, and i concluded wi h
posi i e eedback owa ds con inuing wi h he silen
ecapi ula ion o slides a session end and es ing o be
con inued. Howe e , we would like o poin ou some
pe cei ed limi a ions o his p ojec . As his was a
ocused, sho pilo p ojec comple ed wi hin a limi ed
ime, we needed o assess he s uden 's pe cep ion o he
quali y o MCQ, slides, and in e ac ions o
acili a o /mode a o s. Simila ly, eache s/ acili a o s'
o e all pe cep ions o s uden pe o mance and
in e ac ion we e no e alua ed. Ra he han indi idual
pe o mance, he s udy ocused on o e all g oup
pe o mance. The o he limi a ion is conduc ing his
s udy using a medium-sized g oup in a pos g adua e
depa men wi h ad anced lea ne s. Thus, i s applicabili y
in la ge g oup se ings and unde g adua e eaching needs
u he e alua ion. Also, 20 minu es o a slide
p esen a ion may need o be longe o some opics and
ha e o be chosen ca e ully wi hou a ec ing he
p og ession o s uden lea ning. A signi ican limi a ion
is ha no all s uden s can answe a a p ede e mined ime
because o he eme gency na u e o he clinical p ac ice,
pe sonal illness/issues, e c., as i became appa en ha
his es was olun a y and op ional. Google Fo ms and
o he online quizzes a e good assessmen ools. S ill, hey
ha e allacies o being dependen on in e ne connec i i y
and answe s a ailable o e he in e ne , hus in alida ing
assessmen and, mos impo an ly, ques ion aming.
Though MCQ, EMCQ, and SAQ a e alid assessmen
ools, hey need o be assessed o alidi y and eliabili y
pos hoc. The inal sample size o 22 was pu posi e o
include all JR's. Pos -s udy calcula ion o o al sample
size using day 1 MCQ sco es om g oups R and NR came
as 9 pe g oup ( o al 18) using 1:1 alloca ion wi h 95% CI
and 80% powe . The e o e, he sample size o 22 was
adequa e. Ou s udy had 14 sessions in each g oup, which
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Cha opadhyay: E ec o end session silen ecapi ula ion o slides
130 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025
was much mo e han he minimal sample size. The
demog aphic cha ac e is ics o any indi idual
iden i ica ion o JRs we e no eco ded, and we did no
eco d indi idual pe o mances. As email de ails we e no
sough in Google Fo ms, i was impossible o iden i y
indi idual esponde s. Fu u e s udies should look in o he
e ec o silen ecapi ula ion o he p esen ed slide a he
end o he session o a la ge sample o s uden s using
he andomiza ion echnique o compa e wi h ano he
educa ion echnique, p e e ably assessed a di e en ime
in e als ( o example o nigh , mon h in e al) and
included a he inal summa i e exam. This echnique
may also be es ed in small g oup se ings o ei e a ing
skills aining and used in unde g adua e and supe -
special y aining - basically, any session using a slide
p esen a ion. The only in es men is a ew minu es o
ecapi ula e he p esen ed slides silen ly.
Conclusion
Fo junio esiden s o anes hesiology, he e is signi ican
sho - e m e en ion o knowledge a e he ecapi ula ion
o slides silen ly a he end o he session compa ed o he
con ol g oup. The sco es all by day 7 and imp o e a
in e nal assessmen due o es -enhanced lea ning wi h
eedback o co ec esponses o MCQs. Mos JRs wan ed
he inno a i e echnique and es s using MCQs on he
se en h day a e he eaching session o con inue in he
u u e.
E hical conside a ions
This wo k was pe o med a e ob aining pe mission om
he espec i e IEC ( e e ence no. IEC/2023/06, da ed
16.10.23) and w i en in o med consen om all
pa icipa ing JRs o he Depa men o Anaes hesiology,
Midnapo e Medical College, India.
A i icial in elligence u iliza ion o a icle
w i ing
We used he G amma ly applica ion o co ec spelling
and g amma . No sen ence sugges ion was accep ed.
Acknowledgmen s
I wan o acknowledge he inpu o P o . Apul Goel and
P o . Ani a Rani o King Geo ge Medical Uni e si y,
Lucknow, who helped inalize he s udy concep and
discussion. D . Sagnik Da a, Senio Residen in he
Depa men o Anaes hesiology a Midnapo e Medical
College, helped wi h s a is ics and g aphical
ep esen a ion. D . Debasish Bha , Associa e P o esso ,
amed and collec ed some Google quizzes. All o he
acul y and junio esiden s o he Depa men o
Anaes hesiology a Midnapo e Medical College
pa icipa ed wholehea edly in he s udy.
Con lic o in e es s a emen
This s udy was my Ad anced Cou se in Medical
Educa ion p ojec . In Feb ua y 2024, i was p esen ed as
a pos e a KGMU Lucknow, India, in he p esence o
assesso s appoin ed by he NMC.
Au ho con ibu ions
Concep ion, implemen a ion, collec ing, ga he ing
suppo i e da a, da a analysis, and inal p esen a ion.
Funding
No unds, dona ions, o ex e nal help we e made
a ailable o his s udy.
Da a a ailabili y s a emen
All da a a e collec ed om Google Fo m quizzes,
eco ded in an Excel shee , and a ailable a eques . SAQ
om he i s in e nal assessmen is in physical copy
mode and kep in he Depa men .
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