Interactive spaced-education to teach the physical examination: a randomized controlled trial.

Full Abstract

BACKGROUND:
Several studies have documented that physical examination knowledge and skills are limited among medical trainees.

OBJECTIVES:
The objective of the study is to investigate the efficacy and acceptability of a novel online educational methodology termed 'interactive spaced-education' (ISE) as a method to teach the physical examination.

DESIGN:
The design of the study is randomized controlled trial.

PARTICIPANTS:
All 170 second-year students in the physical examination course at Harvard Medical School were eligible to enroll.

MEASUREMENTS:
Spaced-education items (questions and explanations) were developed on core physical examination topics and were content-validated by two experts. Based on pilot-test data, 36 items were selected for inclusion. Students were randomized to start the 18-week program in November 2006 or 12 weeks later. Students were sent 6 spaced-education e-mails each week for 6 weeks (cycle 1) which were then repeated in two subsequent 6-week cycles (cycles 2 and 3). Students submitted answers to the questions online and received immediate feedback. An online end-of-program survey was administered.

RESULTS:
One-hundred twenty students enrolled in the trial. Cycles 1, 2, and 3 were completed by 88%, 76%, and 71% of students, respectively. Under an intent-to-treat analysis, cycle 3 scores for cohort A students [mean 74.0 (SD 13.5)] were significantly higher than cycle 1 scores for cohort B students [controls; mean 59.0 (SD 10.5); P < .001], corresponding to a Cohen's effect size of 1.43. Eighty-five percent of participants (102 of 120) recommended the ISE program for students the following year.

CONCLUSIONS:
ISE can generate significant improvements in knowledge of the physical examination and is very well-accepted by students.

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Author information

Author/s: Kerfoot, B Price (BP); Armstrong, Elizabeth G (EG); O'Sullivan, Patricia N (PN);

Affiliation: Veterans Affairs Boston Healthcare System, Boston, MA, USA. price.kerfoot(-atsign-)gmail.com

Journal and publication information

Publication Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine (J Gen Intern Med), published in United States. (Language: eng)

Reference: 2008-Jul; vol 23 (issue 7) : pp 973-8

Dates: Created 2008/07/09; Completed 2008/08/29;

PMID: 18612727, status: MEDLINE (last retrieval date: 11/6/2008)

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