multi-faceted e-learning: COMPARISON OF METHODS STUDY #2

Gregory Thompson*, Robert Morrison, and Keith Holyoak; MD Informatics, Salt Lake City, UT 84103, U.S.A.; Northwestern University,  Evanston, IL 60208, U.S.A.; and UCLA, Los Angeles, CA 90095, U.S.A.

PURPOSE: Case-based learning (CBL) can be an effective web-based instructional method. However, specifically what effect a CBL component of multi-faceted instructional programs has on learning when compared to similar programs without a CBL component remains unknown. Thus, this study compared two web-based instructional methods and also compared the effects of time-massed versus time-spaced study on long-term knowledge retention.

METHODS: Using an entirely web-based program, 119 Internal Medicine housestaff were surveyed about their perceived bioterrorism preparedness and pre-tested on bioterrorism concepts. Subjects were then randomly assigned to one of four different online study groups, based upon study type (didactics plus cases versus didactics plus reading) and study schedule (time-massed versus 6-week time-spaced study), and then post-tested with online multiple-choice testing and targeted case simulations.

RESULTS: Upon survey, of eight medical specialties, subjects felt least prepared in bioterrorism, although 83% agreed that it’s their responsibility to respond medically to a local bioterrorism event. Subjects studying with cases were better than reading group subjects in several target case performance metrics, such as diagnostic accuracy (p=0.04) and therapeutic efficiency (p<0.05). There were trends toward faster case solution time and better pre-test to post-test improvement in the case groups versus the reading groups. However, there were no reliable interactions between the study type and study schedule.

CONCLUSION/FUTURE DIRECTIONS: There is discrepancy between perceived bioterrorism readiness and responsibility among physicians-in-training. The case-based component improved the overall pedagogical efficacy of this multi-faceted web-based instructional approach. Additional and more diverse CBL environments should be studied for similar effects.