An analytic study of knowledge retention at different time intervals among junior residents following recapitulation of presented slides silently at the end of teaching session

Copy igh © 2025 Zanjan Uni e si y o Medical Sciences. Published by Zanjan Uni e si y o Medical Sciences. This wo k is licensed unde a C ea i e Commons A ibu ion-NonComme cial 4.0 In e na ional license (h ps://c ea i ecommons.o g/licenses/by- nc/4.0/). Noncomme cial uses o he wo k a e pe mi ed, p o ided he o iginal wo k is p ope ly ci ed. 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 ] 1 / 9 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 [ DOI: 10.61186/edcj.18.1.123 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 2 / 9 Cha opadhyay: E ec o end session silen ecapi ula ion o slides Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1¦ 2025 125lopmen ¦ 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 [ DOI: 10.61186/edcj.18.1.123 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 3 / 9 Cha opadhyay: E ec o end session silen ecapi ula ion o slides 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 [ DOI: 10.61186/edcj.18.1.123 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 4 / 9 Cha opadhyay: E ec o end session silen ecapi ula ion o slides Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1¦ 2025 127lopmen ¦ 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. [ DOI: 10.61186/edcj.18.1.123 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 5 / 9 Cha opadhyay: E ec o end session silen ecapi ula ion o slides 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 [ DOI: 10.61186/edcj.18.1.123 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 6 / 9 Cha opadhyay: E ec o end session silen ecapi ula ion o slides Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1¦ 2025 129lopmen ¦ 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 [ DOI: 10.61186/edcj.18.1.123 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] 7 / 9 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 . 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[h ps://doi.o g/doi: 10.1186/s12911-018- 0661-3] [ DOI: 10.61186/edcj.18.1.123 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ] Powe ed by TCPDF (www. cpd .o g) 9 / 9