Nursing Is Evidence-Based. Is Nursing Education?

We teach students to ask of every intervention: what does the evidence say?

It is one of the best things about our profession. Yet the way students study often runs on habit, and so, sometimes, does the way we teach.

The habits, and what the evidence says about each

Rereading is the strategy students report most ^[1]. It feels productive because the page looks familiar, but familiarity is not recall. The classic study below shows the trap: rereading wins the first few minutes and loses the week ^[3].

Highlighting is rated low utility too ^[2]. It can keep a student on the surface of a text, marking sentences instead of connecting ideas.

Listening to podcasts and recorded lectures fits a busy schedule, and it can help: in one study, students who listened to a recorded lecture and took notes outscored students who heard it live ^[4]. Listening alone, though, is passive review, much like rereading. It builds exposure, not recall, so it works best paired with retrieval.

Cramming gives a short-term bump and fast forgetting. Across hundreds of experiments, the same hours spread over days beat one long session ^[5].

A habit that comes from a good place

Some of us keep it vague what will be on the exam, out of a well-meant worry that students will only study to the test. The evidence points the other way. When students know exactly what they are expected to learn, they learn more, and the gains are largest for first-generation and underserved students ^[6].

If the exam measures the objectives, studying the objectives is not gaming the test. It is learning.

The good news is that the learning sciences give the classroom what evidence gives the bedside: a clear standard.

Three practices with the strongest support

Retrieval practice. Pulling information out of memory strengthens it more than reading it again. In the study above, students who practiced recall remembered about 50% more a week later ^[3].

Spacing. Reviewing across days and weeks, right before material fades, beats massed review in study after study ^[5].

Feedback. Explaining why an answer is right or wrong raises later scores and keeps students from learning the wrong answer from a tempting option ^[7].

Putting all three into every week

NurseSavvy was built to put all three into every week of a course. Lessons end in recall, cards return right before they fade, and every question explains every option. Here is what that looks like, and what our own data shows so far ^[8].

Evidence-based practice belongs in the classroom as much as at the bedside.

— David Zimmerman, MSN, RN, founder of NurseSavvy

Sources

1. Karpicke, Butler & Roediger (2009). Metacognitive strategies in student learning. Memory 17(4), 471–479.
2. Dunlosky et al. (2013). Improving students’ learning with effective learning techniques. Psychological Science in the Public Interest 14(1), 4–58.
3. Roediger & Karpicke (2006). Test-enhanced learning. Psychological Science 17(3), 249–255.
4. McKinney, Dyck & Luber (2009). iTunes University and the classroom: Can podcasts replace professors? Computers & Education 52(3), 617–623.
5. Cepeda et al. (2006). Distributed practice in verbal recall tasks. Psychological Bulletin 132(3), 354–380.
6. Winkelmes et al. (2016). A teaching intervention that increases underserved college students’ success. Peer Review 18(1/2), 31–36.
7. Butler & Roediger (2008). Feedback enhances the positive effects and reduces the negative effects of multiple-choice testing. Memory & Cognition 36(3), 604–616.
8. NurseSavvy learning data, October 14, 2026. Cards return partly by mastery, so this is accuracy on reviewed cards. No NCLEX pass-rate data yet.