A randomised controlled trial of a blended learning education intervention for teaching evidence-based medicine

Abstract

BackgroundFew studies have been performed to inform how best to teach evidence-based medicine (EBM) to medical trainees. Current evidence can only conclude that any form of teaching increases EBM competency, but cannot distinguish which form of teaching is most effective at increasing student competency in EBM. This study compared the effectiveness of a blended learning (BL) versus didactic learning (DL) approach of teaching EBM to medical students with respect to competency, self-efficacy, attitudes and behaviour toward EBM.MethodsA mixed methods study consisting of a randomised controlled trial (RCT) and qualitative case study was performed with medical students undertaking their first clinical year of training in EBM. Students were randomly assigned to receive EBM teaching via either a BL approach or the incumbent DL approach. Competency in EBM was assessed using the Berlin questionnaire and the ‘Assessing Competency in EBM’ (ACE) tool. Students’ self-efficacy, attitudes and behaviour was also assessed. A series of focus groups was also performed to contextualise the quantitative results.ResultsA total of 147 students completed the RCT, and a further 29 students participated in six focus group discussions. Students who received the BL approach to teaching EBM had significantly higher scores in 5 out of 6 behaviour domains, 3 out of 4 attitude domains and 10 out of 14 self-efficacy domains. Competency in EBM did not differ significantly between students receiving the BL approach versus those receiving the DL approach [Mean Difference (MD)=−0.68, (95% CI–1.71, 0.34), p=0.19]. No significant difference was observed between sites (p=0.89) or by student type (p=0.58). Focus group discussions suggested a strong student preference for teaching using a BL approach, which integrates lectures, online learning and small group activities.ConclusionsBL is no more effective than DL at increasing medical students’ knowledge and skills in EBM, but was significantly more effective at increasing student attitudes toward EBM and self-reported use of EBM in clinical practice. Given the various learning styles preferred by students, a multifaceted approach (incorporating BL) may be best suited when teaching EBM to medical students. Further research on the cost-effectiveness of EBM teaching modalities is required.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0321-6) contains supplementary material, which is available to authorized users.

Online Lectures in Undergraduate Medical Education: Scoping Review (Preprint)

“…Moreover, students showed increased knowledge in the subject material at hand, as evaluated by pre-and post-lecture knowledge assessment [11,[13][14][15]17,19,21,22,24,25,27,[29][30][31][32]. Finally, multiple studies demonstrated that knowledge was equivalent (or better) between students learning through online lectures compared to traditional learning modalities, such as live didactic lectures [8,9,12,19,22,23,25,28,[33][34][35][36][37][38], with the exception of one study that found superior student knowledge acquisition from live lectures [39].…”

“…Regardless of the method of assessment, almost all studies reported high satisfaction and increased knowledge after intervention. Student self-assessment typically revealed positive attitudes toward online lectures as a teaching modality [7,8,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Moreover, students showed increased knowledge in the subject material at hand, as evaluated by pre-and post-lecture knowledge assessment [11,[13][14][15]17,19,21,22,24,25,27,[29][30][31][32].…”

Blended learning versus traditional teaching-learning-setting: Evaluation of cognitive and affective learning outcomes for the inter-professional field of occupational medicine and prevention / Blended Learning versus traditionelles Lehr-Lernsetting: Evaluierung von kognitiven und affektiven Lernergebnissen für das interprofessionelle Arbeitsfeld Arbeitsmedizin und Prävention

“…E-Learning allein beschrieben (Bruff, Fisher, McEwen & Smith, 2013;Dziuban, Hartmann & Moskal, 2004;Kröncke, 2010;Means, Toyama, Murphy, Bakia, & Jones, 2010;Morton et al, 2016). Andererseits gibt es aber auch Evidenz, die zeigt, dass Blended Learning nicht effektiver ist als ein traditionelles Lehr-Lernsetting (Güzer & Caner, 2014;Ilic, Nordin, Glasziou, Tilson & Villanueva, 2015;Reasons, Valadares & Slavkin, 2005;Tosun 2015 (Koraneekij & Khlaisang, 2015;Kröncke, 2010;Rowe, Frantz & Bozalek, 2012). Bezogen auf die kognitiven Langzeiteffekte von Blended Learning gibt es nur wenige Studien und diese haben ebenso divergierende Aussagen.…”

“…Studienergebnisse zur Auswirkung von Blended Learning auf die affektive Leistungsdimension sind im Vergleich zur Auswirkung auf die kognitive Leistungsdimension eindeutiger: Blended Learning fördert die Entwicklung einer professionellen Haltung und Einstellung bzw. steigert die Nutzung der gelernten Inhalte in der klinischen Praxis (Ilic et al, 2015). Die Steigerung der Motivation und der Zufriedenheit der Studierenden sind weitere positive Effekte (Güzer & Caner, 2014;Poonam & Prajana, 2016;River, Currie, Crawford, Betihavas, & Randall, 2016, Ruiz et al, 2006.…”

“…Blended Learning führt vom passiven hin zum aktiven Lernen der Studierenden, weil sie durch reale Fallbearbeitung gezwungen sind, selbst zu lesen, zu sprechen, zuzuhören und zu denken und sich selbst zu organisieren (Kaur, 2013). Nicht zuletzt werden durch Blended Learning verschiedene Lerntypen und Lerngeschwindigkeiten berücksichtigt, es kann bedürfnisorientiert gelernt werden und dies fördert einen individuellen und damit personalisierten Lernprozess (Ebner et al, 2013;Ilic et al, 2015). In bisherigen Studien zu Blended Learning werden die kognitive und die affektive Leistungsdimension wenig detailliert betrachtet.…”