Flashcard app for nursing training: despite shift work

Three years, at least 2,100 hours of classroom instruction, at least 2,500 hours of practical training, and in between early, late and night shifts. On r/Pflege, a trainee describes exactly this: exams are coming up, shifts keep changing, and there is hardly any time to study. Another writes that she forgets the material quickly while it keeps growing.

A flashcard app is built for exactly this situation: short sessions that adapt to your shift schedule instead of the other way around. This page shows you how that works with checkst and what flashcards in nursing cannot do.

What awaits you in training

Since 2020 the Nursing Professions Act applies, and training is generalist: elderly care, hospital care and paediatric nursing in one. At the end come three examination parts:

• Written: three case-based supervised papers of 120 minutes each, usually on three consecutive working days.
• Oral: 30 to 45 minutes per person, one complex case task with legal, ethical and scientific justification.
• Practical: a real nursing situation with at least two people, with care plan, implementation and reflection.

Before that, at the end of the second third, comes the intermediate examination. Study covers anatomy and physiology, disease theory, drug groups, hygiene, nursing models such as Orem or Krohwinkel, and the DNQP expert standards, for example on pressure ulcer and fall prevention.

What belongs on cards and what does not

The examinations are case-based. Factual knowledge alone is not enough, but without factual knowledge you cannot solve any case. Well suited to cards:

• Hygiene: indications and procedures.
• Expert standards: the core criteria, for example when a risk assessment is due.
• Scales and values: Braden, shock index, vital signs.
• Drug groups: indications, contraindications.
• Nursing models: who, what, which core concept.

In a thread on the intermediate examination, someone lists nursing models, communication models, law, ethics and expert standards as the topics they repeated deliberately. What does not belong on cards: the care plan for the case in the practical examination. You practise that on the ward.

Your workflow with checkst

1. Cards without copying out. A post on r/Pflege names writing cards as a time sink. In checkst you photograph the page from class or from I care, and text recognition extracts the text. Or you have card suggestions generated from the photo or PDF, on the device via Apple's Foundation Models or with your own OpenAI key. You review and keep what is correct.

2. Context on the card. The same post complains about isolated facts without context. Add what you need it for: not just "Braden scale", but what a low value means for your care planning.

3. Five minutes instead of two hours. checkst uses FSRS to plan how many cards are due today. The home screen widget shows you the number. Five minutes during a break, five on the train. Your decks are stored on the device, so this works without a network too. After three night shifts in a row the streak may be gone. The cards are still there and waiting for you.

4. Phone without distraction. In the exam thread, someone describes the phone as a distraction while studying. If that applies to you: put the checkst widget on your home screen. Then you see the due cards before you land in three other apps.

5. Target retention. According to the Anki manual, 90 percent is the standard, and above 97 percent the effort rises drastically. If you did not know something: "Again", not "Hard".

6. With the course. Set up a study group in checkst, share your deck for the intermediate examination, invite via QR code. Whoever has early shifts does the hygiene cards, whoever has late shifts the pharmacology.

Example cards

And because the Braden card alone achieves nothing: make a second one. "When must the pressure ulcer risk first be assessed according to DNQP?" Answer: immediately at the start of the nursing assignment.

What the research says

The most interesting study comes from Norway. In 2025, Ingebrigtsen and colleagues gave nursing students at 19 sites digital flashcards, with 799 students involved in total. Only about a third of the intervention group used the cards at all. Those who used them did better in the examination. Because it was not randomly decided who used the cards, this is not a clean causal proof, but it is a clear signal. And the lesson from it: the best app is the one you actually open.

Khalafi and colleagues showed in 2024, in a randomised study, that three times 30 minutes of teaching with breaks held up better than 90 minutes in one go. A study on Anki in German nursing training does not exist.

Limitations

• No replacement for practice. The practical examination takes place on a human being.
• No ready-made content. No nursing deck from us, no I care content.
• Check AI suggestions. Especially for hygiene and medication, your school material applies, not the suggestion.
• Apple only. iPhone and iPad. If half your course uses Android, you share decks only via Anki files.