Effective, Scalable, and Low Cost: The Use of Teacher-Made Digital Flashcards Improves Student Learning

Spaced retrieval practice can improve learning but is often underutilized. We hypothesized that providing students with digital flashcards via a spaced repetition app could improve academic performance by increasing use of spaced retrieval practice. In a controlled nationwide quasi-experiment, involving 799 first-year nursing students across 19 Norwegian campuses, we randomly assigned 10 campuses to an intervention. Although only one-third of the intervention group utilized the flashcards, evidence for self-selection bias was limited. Card users significantly outperformed non-users on the final exam (d = 0.42, p < 0.001), were nearly three times more likely to pass (OR = 2.84 [1.35, 6.01]), and over twice as likely to achieve the highest grade (OR = 2.31 [1.35, 3.98]). Flashcard use remained a significant predictor of exam performance after controlling for age, prior academic performance, study time, and study material covered. This suggests that teacher-made digital flashcards can be a cost-effective intervention to improve learning outcomes.