Advancing CKSA: Integrating Spaced Repetition to Strengthen Knowledge Retention

As part of ABFM’s commitment to providing high-quality, relevant assessment tools , we’re excited to introduce spaced repetition into the Continuous Knowledge Self-Assessment (CKSA) activity.

Beginning January 1, 2026, each quarterly CKSA activity will feature 30 questions, including five personalized spaced repetition questions and 25 new questions.

What is Spaced Repetition?

Spaced repetition is an evidence-based learning technique proven to strengthen the retention of critical clinical information over time. By strategically revisiting key concepts at set intervals, the CKSA activity now helps ensure that the knowledge you gain is retained for long-term application in your practice.

What’s Changing?

Beginning in Q1, each quarterly CSKA activity will increase from 25 to 30 questions. These five additional questions are personalized for you and are selected to reinforce learning by intentionally revisiting foundational care concepts you have previously seen. Questions are prioritized by those answered incorrectly or those you answered correctly but self-ranked as “not confident” in previous quarters.

Why it Matters

The integration of spaced repetition into the CKSA activity is specifically designed to reinforce your learning experience and strengthen the long-term retention of critical clinical information, ensuring that your ABFM Board Certification directly supports your ongoing professional growth and builds greater confidence in the care you provide.

In ABFM’s recent large scale study (The Effect of Spaced Repetition on Learning and Knowledge Transfer in a Large Cohort of Practicing Physicians) physicians exposed to repeated exam questions demonstrated significantly improved learning rates (58%) compared to those in the control groups (43%). The integration of spaced repetition has also shown a nearly 6% improvement in knowledge transfer – the ability to apply what was learned to different clinical contexts.

“This study highlights how spaced repetition can be implemented among practicing [family] physicians on a large scale. Revisiting, over time, knowledge self-assessment questions initially answered incorrectly, enhances learning, retention of learning, and the ability to transfer concepts from one clinical scenario to another.”

David W. Price, MD, DABFM
Senior Advisor to the President, ABFM

These findings suggest that simply reintroducing a few key questions each quarter can lead to lasting knowledge gains, helping you stay prepared for the evolving demands of patient care.

To learn more about details of this change, please visit our FAQs