Comparative Study Between Conventional Didactic Lectures and MCQ-Based Reinforcement in Enhancing Learning and Retention Among Undergraduate Medical Students

Abstract

Background: Conventional didactic lectures remain widely used in undergraduate medical education; however, passive learning may limit student engagement and long-term retention. Multiple-choice question (MCQ)-based reinforcement may facilitate active recall, formative assessment, and sustained learning. This study compared conventional didactic lectures with MCQ-integrated teaching for improving learning outcomes and knowledge retention among undergraduate medical students. Methods: A prospective quasi-experimental comparative educational intervention study was conducted among Phase III Part 1 MBBS students at a tertiary care teaching institution in Bengaluru, India. Of 248 eligible students, 216 participated (87.1%) and were allocated into two teaching groups of 108 students each. The control group received conventional didactic lectures, whereas the intervention group received didactic lectures supplemented with 25 validated MCQs addressing factual knowledge, interpretation, and clinical application, followed by immediate feedback and explanations. Learning outcomes were assessed using pre-test, immediate post-test, and four-week retention test scores. Student perceptions of MCQ-based reinforcement were assessed using a structured five-point Likert-scale questionnaire. Between-group comparisons were performed using independent t-tests, with paired t-tests used for within-group comparisons. Results: The baseline characteristics and pre-test scores were comparable between groups. The MCQ reinforcement group demonstrated significantly higher post-test scores than the didactic lecture group (79.2 ± 8.1% vs. 67.3 ± 7.8%; p<0.001). The mean improvement from pre-test to post-test was 24.6% in the intervention group compared with 12.2% in the conventional lecture group. Four-week retention scores remained significantly higher in the MCQ reinforcement group (74.8 ± 7.7% vs. 62.4 ± 7.5%; p<0.001). Most students reported that MCQ-based reinforcement improved examination confidence (91%), understanding of concepts (89%), lecture interactivity (88%), long-term retention (87%), attention during lectures (84%), and self-directed learning (81%). Conclusion: Integrating structured MCQ-based reinforcement with conventional didactic lectures significantly improved immediate learning and four-week knowledge retention among undergraduate medical students. MCQ-based reinforcement represents a feasible adjunctive teaching strategy for enhancing learner engagement and retention in competency-based medical education. Key words: Multiple-choice questions, retrieval practice, medical education, conventional didactic lectures, MCQ-based reinforcement, undergraduate medical students, educational measurement.