Lectures constitute a basic component of physiology instruction in scientific and healthcare curricula. Technological progress has allowed a switch from face-to-face to video lectures. Yet, there is no evidence of video efficacy in physiology. Because videos increase the cognitive load during a learning task, identifying tools that decrease students' cognitive load during video is critical. Segmenting videos with pauses and inducing joint attention with eye movements modelling examples (EMME) could reduce the cognitive load and improve second year medical students' learning in physiology video lectures. Second year medical students were randomized into 4 groups (EMME + pauses (EMME+P), EMME without pauses (EMME-NoP), pauses only (NoEMME+P) and no EMME - no pause (NoEMME-NoP)), took pre-tests quizzes, watched a renal physiology video lecture, answered a cognitive load questionnaire and post-tests quizzes on the Moodle{copyright, serif} learning management system. Student's prior knowledge was assessed by a pre-test, and learning gains by the difference between post and pretest scores. One hundred ninety-five students completed the experiment. Pauses improved learning gains (P<0.01), but not EMME (P=0.11). Student's prior knowledge has several interactions with other variables: low prior knowledge students obtained better learning gains (P<0.001), high prior knowledge students had lower learning gains with EMME (P<0.05). Our study shows the potential role of tools designed to reduce students' cognitive load during a renal physiology video lecture, and the critical need to empirical validation of pedagogical solutions that are adapted to the specificities of physiology lectures.
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