Knowledge, Attitude, and Practice of Active Recall and Spaced Repetition among Medical Students at St Paul Hospital Millennium Medical College , Addis Ababa, Ethiopia

Abstract

Abstract Background: Active recall and spaced repetition are evidence-based learning strategies proven to enhance long-term retention and academic performance in medical education. Despite their efficacy, these techniques remain underutilized globally, particularly in settings where formal instruction on study skills is absent. Objectives: This study aimed to assess the knowledge, attitudes, and practices of active recall and spaced repetition among undergraduate medical students at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: A cross-sectional study (September–November 2025) included 261 medical students selected through simple random sampling. Data were collected via a structured, self administered questionnaire adapted from validated tools and analyzed using SPSS v27. Knowledge, attitude, and practice were categorized using predefined criteria, with results summarized using descriptive statistics (frequencies and percentages) Results: Participants were predominantly female (59.4%) and aged 21–23 years (50.2%), with 80.1% reporting no prior formal training in study strategies. Knowledge levels were low: only 31.8% demonstrated adequate understanding of active recall and 33.7% of spaced repetition, while over half were classified as not knowledgeable. Although 82.7% theoretically recognized the strategies’ effectiveness, only 25.7% held a positive overall attitude, largely due to perceived cognitive effort and time demands. Practice patterns revealed a significant theory–practice gap: 46.4% reported low use of active recall, while 55.9% reported high spaced repetition use—a figure likely inflated by misconceptions, as 76.2% still relied on massed cramming. Chi-square analyses indicated that clinical-year progression and prior formal training were significantly associated with improved KAP scores (p < 0.001) Conclusion: Despite recognizing their value, St. Paul’s Hospital Millennium Medical College medical students show limited knowledge and inconsistent use of evidence-based strategies, with moderate underuse of active recall and spaced repetition. This likely stems from lack of formal training and misconceptions about effort and feasibility. The findings highlight the need to integrate structured learning-skills training into the curriculum, adding workshops and peer led sessions to bridge the gap between awareness and effective practice. Keywords: Students, Medical, Active recall/ Spaced repetition, Evidence based practice, Knowledge, Attitude, Practice.