USMLE-Rx provides a study tool, Study Stream, that uses spaced repetition to prioritize flashcard review, so study time is focused on facts that need the most review.
Flashcards are shown based on confidence ratings and response time, while balancing new material with facts that are most likely to be forgotten. As performance improves, cards appear less frequently. If a previously mastered card is missed, it will return sooner for additional review.
Rate Your Confidence
After reviewing each flashcard, rate your confidence level to indicate how well the information is understood:
Nailed It. Select this option if the fact is well understood. The card will return at a much later time.
OK. Select this option if the fact is understood but not fully mastered. The card will return after a longer interval.
Don’t Know. Select this option if the fact is unfamiliar or unclear. The card will be shown again soon for additional review.
Review Timing
When you review cards with Study Stream, the tool adjusts how often flashcards reappear based on confidence ratings over time.
When a card is marked Nailed It, the first return interval is about 4 days. If Nailed It is selected again, the interval extends further to roughly 12 days and continues to increase with repeated strong performance.
When a card is marked OK, it will return after about 1 day. If OK is selected again the next time, the interval extends to roughly 6 days. Continued OK ratings can extend the interval further.
When a card is marked Don’t Know, it will be shown again soon, typically within a few minutes. This applies even if the card was previously rated Nailed It multiple times.
These adjustments allow Study Stream to confirm understanding over time while returning difficult material more frequently.
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