I’ve been teaching NP students a long time. Recently I launched NursingEdAI, a web platform that helps faculty produce educational tools. All the tools are designed with the principles of durable learning. But because I’m never satisfied with how things turn out (I’m the guy who redesigns his courses every semester), I added a new feature. Mel is the AI tool named after the Greek nymph who taught humans to use honey (and, coincidentally, after my most important human education mentor). It’s a structured synthesis of the strongest research on how people learn, specifically in health professions graduate education.
Last week, I ran my own course materials through Mel. Now, remember: I’m ostensibly a durable learning scholar. I study this. And I know how to do durable learning. Theoretically.
The framework
Mel is powered by Cruz (named after another mentor, this one in the scholarship of teaching and learning), a curated collection of the evidence that most strongly supports durable learning, nursing education, clinical education, and online and asynchronous learning. Not opinion. Not tradition. Not what worked when someone was a student.
The five highest-yield principles for durable learning in graduate nursing education are:
Spaced retrieval. Retrieving information across multiple sessions — not all at once — dramatically improves long-term retention. The foundational study by Karpicke and Roediger showed 80% retention at one week with spaced retrieval versus 36% with study-only. That gap holds in medicine and nursing too. A 2025 review across health professions programs found effect sizes ranging from 0.60 to 1.40.
Experience activation. Adult learners have a reservoir of prior clinical experience. New content that connects explicitly to that experience is encoded far more durably than content delivered in a vacuum. Andragogy — Knowles’s framework for adult learning — describes this as the learner’s most important educational resource. We ignore it constantly.
Learning-goal framing. Carol Dweck’s research on growth mindset shows that how we frame learning activities changes what students do when things get hard. “Prepare for your exam” is a performance goal. “Build the reasoning you’ll use in your first year of practice” is a learning goal. The difference in student behavior under difficulty is substantial.
Elaborative feedback. Most quiz feedback tells students what the correct answer is. What builds durable understanding is feedback that explains why the mechanism works the way it does — feedback that connects the new information to what the student already knows.
Problem-centered design. Adults learn clinical content most effectively when it’s anchored to a patient problem from the start, not when it’s presented as abstract subject matter that eventually becomes relevant to a patient problem.
What I found in my own materials
I evaluated four activity types from Week 7 of an Adult Acute Care NP practicum course about neurological problems in critical care—ICP management, subarachnoid hemorrhage, ischemic stroke, status epilepticus.
The clinical content was strong. The case study was realistic. The quiz questions were application-leve, not simply recall. The Canvas page opened with one of the best clinical vignettes I’ve written: a patient with the worst headache of her life, a falling GCS, CSF with xanthochromia and non-decreasing RBCs across tubes. The opening question was exactly what I’d ask students in clinical practice. But, Mel identified some real ways to improve the content.
Every activity was designed for one session. Students engage with Week 7 content, then don’t see it again in a structured way until the midterm exam. The literature is unambiguous about what this produces. A landmark study by Larsen in emergency medicine showed that learners who reviewed content via spaced retrieval over the following weeks retained more than twice as much at six months compared to those who attended a single lecture with no follow-up. My Week 7 content had zero built-in spaced follow-up.
Not one activity asked students to connect the content to their prior clinical experience. These students are experienced ICU and acute care nurses. Many of them have cared for SAH patients, managed ventriculostomies, watched neurological deterioration in real time. Their clinical experience is an encoding resource I wasn’t using at all.
The quiz framing was performance-oriented. “Test your clinical decision-making with scenarios matching the difficulty of your graded quiz.” That’s a performance goal. It tells students the point of the quiz is to perform well on the next graded assessment. That framing changes how students engage with difficulty.
What I changed before posting the week
Three changes, none of which required writing new clinical content.
I added 3-question mini-quizzes to be posted at Day 3 and Day 7 after the case study. Same material. Different timing. The spacing does the work.
I added a single opening prompt to the case study: “Before you begin — think of a neurological patient you cared for as an RN. What was the most difficult clinical decision moment in that patient’s course? Keep that patient in mind as you work through this case.” That’s the experience activation. One sentence.
I rewrote the quiz intro to read: “These 12 scenarios build the clinical reasoning you’ll need in your first independent year of practice. Work through them to find where your thinking is solid and where you need more time.” That’s the framing shift.
Small changes. Each one grounded in evidence.
What this means for faculty
I’m not special. If I missed these structural elements after 30 years of teaching, you might be missing them too. Not because you don’t care about your students — clearly you do. But because these principles aren’t taught in most graduate nursing programs, and they’re not visible in a curriculum map or a course shell.
The content quality in most nursing education programs is good. The retrieval architecture is often weak.
This is what NursingEdAI is designed to address — not by replacing your clinical judgment or your course design, but by embedding the evidence base into the generation of every activity, automatically.
A quiz that spaces retrieval across three sessions doesn’t require more work from you. It just requires knowing that’s how durable learning works.
I’m going to keep auditing my own courses with Cruz. I’m going to keep making these small changes. And I’m going to keep publishing what I find — because the only way the evidence reaches the classroom is if people who know it share it.
That’s what this newsletter is for.
— Paul Logan, PhD, CRNP
paulloganphd.com