Spaced repetition learning simply means distributing your review of material over time. Substantial evidence over the past two decades has shown that spaced review intervals lead to significantly better long-term memory retention (1-3). Headmirror’s OtoRecall app takes advantage of spaced repetition learning using an algorithm that progressively spaces review of previously learned content over time. Moreover, the algorithm has “memory,” where topics that the user finds particularly difficult to learn are reviewed at closer intervals compared to topics that the user finds easy to learn. Unlike other available spaced repetition software, the OtoRecall app’s spaced repetition platform is specifically designed for the uniquely busy 5-year learning course that is otolaryngology residency.

Of particular importance for learning amidst a busy residency schedule, several studies have also shown that spaced repetition learning leads to better long-term retention regardless of the exact relative spacing between review periods (4,5). In other words, your long-term retention results are more influenced by consistent effort over time than by staying exactly on schedule with the app’s “ideal” learning schedule.

(1) Dunlosky J, Rawson KA, Marsh EJ, Nathan MJ, Willingham DT. Improving Students' Learning With Effective Learning Techniques: Promising Directions From Cognitive and Educational Psychology. Psychol Sci Public Interest. 2013 Jan;14(1):4-58.

(2) Feng K, Zhao X, Liu J, Cai Y, Ye Z, Chen C, Xue G. Spaced Learning Enhances Episodic Memory by Increasing Neural Pattern Similarity Across Repetitions. J Neurosci. 2019 Jul 3;39(27):5351-5360.

(3) Kelley P, Whatson T. Making long-term memories in minutes: a spaced learning pattern from memory research in education. Front Hum Neurosci. 2013 Sep 25;7:589.

(4) Karpicke JD, Bauernschmidt A. Spaced retrieval: absolute spacing enhances learning regardless of relative spacing. J Exp Psychol Learn Mem Cogn. 2011 Sep;37(5):1250-7.

(5) Karpicke JD, Roediger HL. Is expanding retrieval a superior method for learning text materials? Mem Cognit. 2010 Jan;38(1):116-24.

Perhaps of even greater importance than spaced repetition in long-term memory retention is taking advantage of active recall when studying. Active recall (or practice testing) encompasses the act of intentionally retrieving learned material from your brain rather than passively reviewing material (i.e., answering questions – particularly on previously learned material – rather than reviewing a previously highlighted book chapter). When performed repeatedly over time, the use of active recall has been demonstrated to yield substantial improvements in long-term memory in a variety of studies (1-5). It is worth keeping in mind that most scenarios as trainees – such as being asked questions in the operating room – require this type of memory, as potential answer choices are often not readily available to cue your memory. The questions within Headmirror’s OtoRecall app were intentionally designed with this principle in mind.

(1) Karpicke JD, Blunt JR. Retrieval practice produces more learning than elaborative studying with concept mapping. Science. 2011 Feb 11;331(6018):772-5.

(2) Roediger HL 3rd, Butler AC. The critical role of retrieval practice in long-term retention. Trends Cogn Sci. 2011 Jan;15(1):20-7.

(3) Azzam MB, Easteal RA. Retrieval Practice for Improving Long-Term Retention in Anatomical Education: A Quasi-Experimental Study. Med Sci Educ. 2021 May 11;31(4):1305-1310.

(4) Larsen DP, Butler AC, Roediger HL 3rd. Comparative effects of test-enhanced learning and self-explanation on long-term retention. Med Educ. 2013 Jul;47(7):674-82.

(5) Liu Y, Rosburg T, Gao C, Weber C, Guo C. Differentiation of subsequent memory effects between retrieval practice and elaborative study. Biol Psychol. 2017 Jul;127:134-147.

The content within the app that you review is completely customizable. Within the Settings section of the app, entire subspecialties or specific subspecialty topics can be turned to “active learning,” “previously learned,” or “off.” These correspond to the green checkmark, yellow recycling sign, and red X, respectively.

A topic that is green will be prioritized as the first content you will see on a given day. Topics designated yellow represent topics you want to continue reviewing as time allows, but studying other content will be prioritized before reviewing the yellow topics daily. Topics that are red will not show up in your daily set of cards.

Within the Library section of the app, the entire card bank is searchable by keyword. Alternatively, you can review different topics by selecting the respective subcategories in each subspecialty.

Similarly, remember that you can use the Library to quickly review specific content as needed (e.g., reviewing high-yield facts about parotid malignancies before a parotidectomy case).

If you would like to provide feedback about the app or you feel that a specific card is incorrect, please submit it through the link provided above.

This depends somewhat on the specific question, but most questions were designed to be answered in about 20 seconds, yielding a goal rate of about 3 questions per minute.

Oftentimes, when using resources like OtoRecall, learners can get bogged down in each question and end up in a 5- or 10-minute rabbit hole looking into a topic. Although at times this may be necessary, the algorithm is intentionally designed to keep you current on learned topics – the goal is not to have the card completely memorized by the time you move on. Given the immense breadth of ENT, attempting to perfectly learn each card before moving on will slow you down and make it impossible to become literate in all areas.

If you feel like you are seeing specific cards too frequently, consider being more generous on your answer choice (e.g., choosing a 5 instead of a 4). If you feel like you are seeing all cards too frequently, consider switching to Cram Mode.

Cards were created through thousands of hours of effort by numerous residents, fellows, and otolaryngology staff across the country with a specific emphasis on distilling the most high-yield content for otolaryngology trainees. A list of primary contributors can be found in the “About Us” page. For each subspecialty, at least one fellowship-trained Subspecialty Editor oversees the topic. Card content is continually updated and revised as developments in the field arise.

The email allows us to easily coordinate resetting your password if it is lost. Emails are not shared with any outside parties.

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The account will be deactivated. This helps to reduce long-term storage demands and keep costs down so that we can continue to offer the app for free.