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Final Program

Administrative / Leadership / Education

1811 - Evaluating an Anki-Based Spaced Repetition Program for PM&R Resident Education

Friday, February 20, 2026
5:00 PM - 6:30 PM AST
Objectives: The Self-Assessment Examination (SAE) is an objective tool used to evaluate knowledge across core domains in Physical Medicine and Rehabilitation (PM&R) and has been shown to correlate with board exam performance. This study evaluated whether a structured Anki-based spaced repetition program could improve resident confidence and SAE performance in musculoskeletal medicine, pain medicine, prosthetics/amputation/gait, and rehabilitation/functional management. We hypothesized that consistent Anki use would be associated with improved SAE scores and greater self-reported confidence.

Design: This prospective educational quality improvement project recruited PM&R residents at UTSW from the classes of 2025 and later. A faculty-reviewed Anki deck of 975 flashcards was developed, targeting historically weaker SAE domains at our institution. Sources included PM&R Board Review (Cuccurullo), Braddom’s PM&R (Cifu), and the AAPM&R KnowledgeNOW database. Baseline confidence in each topic was assessed by survey. Outcomes at 12 months included self-reported confidence in overall knowledge and four subtopics, as well as SAE subtopic scores.

Results: Deck utilization was limited: 13 of 23 residents used the resource, with only one resident engaging daily as intended. Thirteen participants completed the SAE in both 2024 and 2025. Among subtopics, only musculoskeletal medicine showed improvement in percent correct scores year-to-year. No statistically significant changes were found in overall SAE performance or self-reported confidence from baseline to follow-up, though a non-significant trend toward higher confidence was noted among Anki users.

Conclusions: Although spaced repetition with Anki offers strong theoretical benefits for long-term retention, resident adoption in this study was poor. Minimal improvements were observed, without statistically significant gains in SAE scores or confidence. These findings suggest that passive distribution of digital tools is insufficient. Successful implementation may require structured curricular integration, accountability measures, and faculty reinforcement to optimize engagement and achieve meaningful educational outcomes.