AUDITORIUM PRESENTATION

A Prospective, Randomized Trial Evaluating The Efficacy and Attitudes of Students Learning Pediatrics Using Web-Based Tools

Chris Maloney, Jeremy Kendrick, Melvin Wright, Kathy Sward, Stephanie Richardson

University of Utah, Salt Lake City, Utah, USA

ABSTRACT:

Introduction

Students utilize a variety of resources to learn medicine. Traditional methods of student learning include textbooks, didactic sessions and small groups, including problem-based learning. The recent explosion in access to the Internet has allowed for computer-assisted instruction (CAI) as an additional learning strategy. Minimal literature exists evaluating the effectiveness of CAI on learning and retention. The goal of the project is to determine if playing an interactive computer game versus a flash-card question/answer approach results in improved retention of clinical content. Additionally, we wanted to gain qualitative information regarding presentation format for CAI.

Methods

We created two web-based applications to present clinical questions and answers. An interactive “chutes-and-ladders” board game played in teams of medical students is compared to a flash-card display of questions and answers played by individual medical students. In the board game group, students play in teams to determine and provide a spoken response. The opposing teams determine if the spoken answer is correct and if “yes” the responding team moves forward along the board. A board certified general pediatrician acts as a facilitator to extend the clinical content beyond the printed answer. The flash-card group views the questions and answers in rapid succession. The data set for both applications is identical and consists of 390 question/answer pairs corresponding to pediatric clinical medicine. The study consists of 7 1-hr sessions. Sessions 1, 6 and 7 include a pre-test, post-test and follow-up test consisting of 100 randomly selected question/answer pairs from the dataset with 3 distracting multiple choice answers. Sessions 2-5 are interactions with each randomly assigned application. Session 6 also includes a qualitative questionnaire.

Results

Pre-test scores did not differ between groups. Post-test scores increased significantly with both interventions and the improvement was retained on follow-up exam. The post-test score for the flash-card group was significantly higher than the board game group. Qualitative analysis demonstrated that both formats were a superior learning method over a traditional textbook or didactic approach. Students felt the material was relevant to clinical pediatrics. Students in the board game group felt the facilitator was an integral part of the learning process to provide clinical context to the answer. Students in the flash-card group also requested additional details about the answers. The format of question presentation was very important. More participants from the game group felt that the format helped them understand the content, helped them learn better, and they enjoyed learning. Students in the flash-card group reported viewing most all question/answer pairs while the students in the board game group reported viewing less than 100 question/answer pairs.

Discussion

Web-based CAI can be an effective medium to deliver pediatric clinical content. Using a content expert to extend clinical information is highly regarded by students. Working through a large contingent of questions improves testing on a multiple-choice exam. The method of testing knowledge is critical in evaluating the impact of an educational intervention. Recruitment is augmented when students are financially compensated.

BENEFIT TO PARTICIPANTS ATTENDING SESSION:

Participants attending this presentation will gain knowledge into the process of evaluating computer assisted instruction media. They will be provided qualitative and quantitative results from a prospective, randomized trial comparing an interactive "board game" format to a "flash-card" format. Strengths and weaknesses of study design to evaluate computer assisted instruction and knowledge gained by the investigators will be shared with the audience.

Chris Maloney, MD

Chief, Division of Pediatric Inpatient Medicine

University of Utah and Primary Children’s Medical Center 100 N. Medical Drives

Salt Lake City, UT 84113

Phone: 801 588-3283

Fax: 801 588-3814

mailto:chris.maloney@hsc.utah.edu

Website http://msig.med.utah.edu/boardgame/

Website: http://msig.med.utah.edu/boardgame/medflash.html

CO-AUTHORS:

Jeremy Kendrick

Melvin Wright

Kathy Sward

Stephanie Richardson

JK: University of Utah School of Medicine Salt Lake City UT 84113 MW: University of Utah Department of Pediatrics 100 N. Medical Drive Salt Lake City UT 84113

KW: University of Utah School of Nursing Salt Lake City UT 84113 SR: Director, Center for Teaching and Learning Excellence. University of Utah. Salt Lake City UT 84113