Abstract:

Introduction:
The Spaced Repetition System is used for learning complex information. It is based on the premise that the contents are better stored in the long-term memory if the memorization exercises are carried out in short intervals of time, repeating less and less the same contents as they are acquired. Despite the use of physical flash cards, several software have emerged in recent years based on this replication methodology, including gamification aspects.
Flash cards are widely used in elementary education and language schools, but are not common in university health science studies. In nursing studies, this is important because memorizing the names of the drugs and their pharmacological groups allows rapid identification of their effects and adverse reactions during their care activity.
The main objective is to evaluate the implementation of flash cards and their degree of usefulness in nursing students in the subject of Pharmacology.


Methods:
The flash cards were prepared using Anki and Mnemosyne software. Both are open sources and are cross-platform on PC and mobile phone.
First, second-year nursing students were explained the use of the software used in this study. Second, the flipped classroom and cooperative learning methodologies were used, in which students were divided into groups of 2-3 for the elaboration of the flash cards. Thirdly, the teachers reviewed and grouped all flash cards by topics: pharmacological groups. Finally, they were returned to the students to implement the spatial repetition system for the Pharmacology exam.
A pre-test questionnaire was distributed at the beginning of the activity, while the post-test questionnaire was completed on the day of the examination.

Results:
At the beginning of the activity, 67 students participated in the creation of the flash cards. When they were asked about the level of difficulty of the Pharmacology as a subject, they considered that it is a subject that is difficult to memorize in terms of its contents, with an average of 8.36 +- 0.15 points. However, when the system of spaced repetition was explained to them, they quite agreed that it would help them to remember drugs and their characteristics better, with a score of 8.28 +-1.65 points. 47.8% (32) of the student nurses were previously familiar with the spaced repetition system and only 28.4% (19) had used flash cards in the past: all cases in traditional paper format.
After the activity, 1,241 different flash cards were created, divided into 334 for correspondence between generic and brand name drugs, 461about drugs and their pharmacological groups and 446 about the risk categories of drugs during pregnancy according to the Food and Drug Administration (FDA).
Finally, 50% (39) of the students used the flash cards for exam preparation, of which 94.87% (37) used only the Anki program. In this group, students recognized that they learned more by using this methodology (7.43 +- 1.55 points) and pointed out that flash cards would be very useful to them even after they passed the exam (7.85 +-2.05 points).

Conclusions:
The elaboration of flash cards in nursing students in the subject of Pharmacology has proved to be useful for them when they have used the system of spaced repetition. In addition, they also appreciated having these flash cards for their professional future.

Keywords:

Memory, Anki, Mnemosyne, Pharmacology, Nursing.