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Chiropractic Journal of Australia : CJA December 2013
Chiropractic Journal of Australia Volume 43 Number 4 December 2013 137 Introduction Psychologists have long been aware that the brain has a great capacity for storing, processing, and retrieving information.1 This has particular ramifcations for education and as such memory and recall of information has received a lot of interest in recent years.2, 3 The basic sciences are widely taught throughout medicine and the allied health disciplines, and the retention of knowledge of subjects such as anatomy, behavioural sciences, biochemistry, microbiology, pathology, pharmacology, oral biology and physiology, is a growing area of interest in research.4,5 A number of studies have investigated the retention of knowledge of medical science subjects.5-10 These studies have found good levels of retention of approximately 70% or more. Of the studies that have looked at the retention of neuroanatomy in the health profession7-9,11 it appears to be less, at approximately 40% or lower. However, when the information that has been learnt is directly used, the knowledge retention is better,6,7,12 with one study published by Cheifetz et al. showing no signifcant loss of knowledge one year after material was learnt.6 INDEX TERMS: (MeSH): ANATOMY; ANATOMY, NERVOUS SYSTEM; NEUROANATOMY; CHIROPRACTIC; (Other): KNOWLEDGE RETENTION; BASIC SCIENCES. A Cross Sectional Study on the Retention of Neuroanatomy Knowledge by Chiropractic students RACHEL McCOY, STEPHNEY WHILLIER, ANGELA PARKINSON, GHASSAN HIJAZI, KAREN HALL and THI NGUYEN Rachel McCoy, MChiroprac Stephney Whillier, PhD Angela Parkinson, MChiroprac, Ghassan Hijazi, MChiroprac Karen Hall, MChiroprac Thi Nguyen, MChiroprac All: Department of Chiropractic, Faculty of Science, Macquarie University, Sydney, Australia Received: 11 September 2013, Accepted 8 October 2013. Confict of Interest Notifcation: There are no conficts of interest and no commercial or fnancial relationships. ABSTRACT: Objective: Loss of knowledge a year after studying neuroanatomy has been shown to be between 47.5% and 60%. This is in contrast to retention rates of 80% or more for the basic sciences generally. The aim of this study was to measure how much neuroanatomy knowledge was retained by chiropractic students a year after taking a neuroanatomy course. Design: One hundred and twenty one eligible students from two cohorts voluntarily completed a selection of multiple choice questions from the previous year’s fnal examination (2011). The scores for the questionnaire were compared with the previous year's results. Results: The 2012 scores for the combined cohort dropped by 35.8%, and there was no difference between the two cohorts (p=0.1282). However the scores for the two cohorts had been different in 2011 (p=0.005) and surprisingly the weaker cohort retained more information, which could be attributed to their use of the knowledge in a unit of clinical neurology they had taken during 2012. Conclusion: The results of this study demonstrate a better retention of neuroanatomy knowledge by our chiropractic students compared to the current literature. Chiropr J Aust 2013;43: 137-41. The loss of knowledge over time was frst demonstrated empirically by Hermann Ebbinghaus in the 1880's, and has come to be known as the Ebbinghaus' Curve of Forgetting.10,13 (Figure 1) The curve is characterised by large increments of loss over short time periods, followed by a levelling off of the retention of knowledge. Although this curve documents knowledge retention over 31 days, some studies have been done over years. Most studies show some alignment with this curve, but the timescale can vary quite considerably and there is variability in the level of retention.10 Past studies into neuroanatomy have supported the expected rate of decline. However, the Ebbinghaus measurement of retention is confounded by intervening events, one of which is the use of the knowledge learnt, which improves the levels of retention6,7,12 and according to Custers10 results in a delay before any decline in knowledge i.e. shifts the Ebbinghaus curve to the right. The aim of our study was to determine how much of the content of a course of undergraduate neuroanatomy was retained after one year, in two groups of chiropractic students who took the same course, and compare this to the results of previous research within the medical and dental discipline. A secondary aim was to compare the two cohorts we were following, in order to note any differences, because whilst one of the groups (HLTH214) went into third year in which there were no neurology studies that year, the second group (HLTH308) went into frst year chiropractic masters (4th year) in which they were required to apply the knowledge in a course of clinical neurology. We hypothesised that neuroanatomy knowledge retention in chiropractic students would be higher than the average given in the research, and when compared to the exponential decrease in the Ebbinghaus Curve of Forgetting (Figure 1)
CJA September 2013