Does pre-testing promote better retention than post-testing?

Latimier, Alice; Riegert, Arnaud; Peyre, Hugo; Ly, Son Thierry; Casati, Roberto; Ramus, Franck

doi:10.1038/s41539-019-0053-1

Cited by 38 publications

(47 citation statements)

References 32 publications

(50 reference statements)

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“…Though necessary to assess participants’ knowledge and attitudes regarding PPE prior to the interventions, the first set of questions, along with the study title, might have acted as a primer and focused the participants’ attention on the specific contents that would be tested postintervention [ 26 ]. This effect might have further dampened the potential impact of the e-learning module.…”

Section: Discussionmentioning

confidence: 99%

Effect of an E-Learning Module on Personal Protective Equipment Proficiency Among Prehospital Personnel: Web-Based Randomized Controlled Trial

Suppan¹,

Abbas²,

Stuby³

et al. 2020

J Med Internet Res

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Background To avoid misuse of personal protective equipment (PPE), ensure health care workers’ safety, and avoid shortages, effective communication of up-to-date infection control guidelines is essential. As prehospital teams are particularly at risk of contamination given their challenging work environment, a specific gamified electronic learning (e-learning) module targeting this audience might provide significant advantages as it requires neither the presence of learners nor the repetitive use of equipment for demonstration. Objective The aim of this study was to evaluate whether a gamified e-learning module could improve the rate of adequate PPE choice by prehospital personnel in the context of the coronavirus disease (COVID-19) pandemic. Methods This was an individual-level randomized, controlled, quadruple-blind (investigators, participants, outcome assessors, and data analysts) closed web-based trial. All emergency prehospital personnel working in Geneva, Switzerland, were eligible for inclusion, and were invited to participate by email in April 2020. Participants were informed that the study aim was to assess their knowledge regarding PPE, and that they would be presented with both the guidelines and the e-learning module, though they were unaware that there were two different study paths. All participants first answered a preintervention quiz designed to establish their profile and baseline knowledge. The control group then accessed the guidelines before answering a second set of questions, and were then granted access to the e-learning module. The e-learning group was shown the e-learning module right after the guidelines and before answering the second set of questions. Results Of the 291 randomized participants, 176 (60.5%) completed the trial. There was no significant difference in baseline knowledge between groups. Though the baseline proportion of adequate PPE choice was high (75%, IQR 50%-75%), participants’ description of the donning sequence was in most cases incorrect. After either intervention, adequate choice of PPE increased significantly in both groups (P<.001). Though the median of the difference in the proportion of correct answers was slightly higher in the e-learning group (17%, IQR 8%-33% versus 8%, IQR 8%-33%), the difference was not statistically significant (P=.27). Confidence in the ability to use PPE was maintained in the e-learning group (P=.27) but significantly decreased in the control group (P=.04). Conclusions Among prehospital personnel with an already relatively high knowledge of and experience with PPE use, both web-based study paths increased the rate of adequate choice of PPE. There was no major added value of the gamified e-learning module apart from preserving participants' confidence in their ability to correctly use PPE.

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Section: Discussionmentioning

confidence: 99%

Effect of an E-Learning Module on Personal Protective Equipment Proficiency Among Prehospital Personnel: Web-Based Randomized Controlled Trial

Suppan¹,

Abbas²,

Stuby³

et al. 2020

J Med Internet Res

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“…Baseline knowledge and self-confidence regarding the use of PPE were assessed by a second set of 22 questions, only four of which were specifically related to the choice of PPE. This rather high overall number of initial questions was designed to limit the priming effect [ 16 ], one of the potential shortcomings hypothesized in a previous publication [ 12 ]. These questions were followed by the intervention.…”

Section: Methodsmentioning

confidence: 99%

“…This interactive module was created under Articulate Storyline 3 (Articulate Global, New York, USA). Feedback [ 19 ], pretesting [ 16 ], avoiding content skipping [ 20 , 21 ], embedded videos [ 22 ] and gamification [ 23 ] were used as learning mechanics. Gamification was used for donning and doffing sequences.…”

Section: Methodsmentioning

confidence: 99%

Impact of an e-learning module on personal protective equipment knowledge in student paramedics: a randomized controlled trial

Suppan

Stuby

Gartner

et al. 2020

Antimicrob Resist Infect Control

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Background Prehospital professionals such as emergency physicians or paramedics must be able to choose and adequately don and doff personal protective equipment (PPE) in order to avoid COVID-19 infection. Our aim was to evaluate the impact of a gamified e-learning module on adequacy of PPE in student paramedics. Methods This was a web-based, randomized 1:1, parallel-group, triple-blind controlled trial. Student paramedics from three Swiss schools were invited to participate. They were informed they would be presented with both an e-learning module and an abridged version of the current regional prehospital COVID-19 guidelines, albeit not in which order. After a set of 22 questions designed to assess baseline knowledge, the control group was shown the guidelines before answering a set of 14 post-intervention questions. The e-learning group was shown the gamified e-learning module right after the guidelines, and before answering post-intervention questions. The primary outcome was the difference in the percentage of adequate choices of PPE before and after the intervention. Results The participation rate was of 71% (98/138). A total of 90 answer sets was analyzed. Adequate choice of PPE increased significantly both in the control (50% [33;83] vs 25% [25;50], P = .013) and in the e-learning group (67% [50;83] vs 25% [25;50], P = .001) following the intervention. Though the median of the difference was higher in the e-learning group, there was no statistically significant superiority over the control (33% [0;58] vs 17% [− 17;42], P = .087). The e-learning module was of greatest benefit in the subgroup of student paramedics who were actively working in an ambulance company (42% [8;58] vs 25% [− 17;42], P = 0.021). There was no significant effect in student paramedics who were not actively working in an ambulance service (0% [− 25;33] vs 17% [− 8;50], P = .584). Conclusions The use of a gamified e-learning module increases the rate of adequate choice of PPE only among student paramedics actively working in an ambulance service. In this subgroup, combining this teaching modality with other interventions might help spare PPE and efficiently protect against COVID-19 infection.

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“…We used previously identified resources to establish the theoretical background [20,[31][32][33][34][35][36][37]. These resources were extracted from Verschueren et al [22], which described the development of a serious game designed to reduce perioperative anxiety in children, and from our recent study describing the development of a gamified e-learning module that was used to teach the adequate use of PPE to prehospital personnel in the context of the COVID-19 pandemic [23].…”

Section: Theoretical Basismentioning

confidence: 99%

A Serious Game Designed to Promote Safe Behaviors Among Health Care Workers During the COVID-19 Pandemic: Development of “Escape COVID-19”

Suppan¹,

Catho²,

Nunes³

et al. 2020

JMIR Serious Games

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Background As many countries fear and even experience the emergence of a second wave of COVID-19, reminding health care workers (HCWs) and other hospital employees of the critical role they play in preventing SARS-CoV-2 transmission is more important than ever. Building and strengthening the intrinsic motivation of HCWs to apply infection prevention and control (IPC) guidelines to avoid contaminating their colleagues, patients, friends, and relatives is a goal that must be energetically pursued. A high rate of nosocomial infections during the first COVID-19 wave was detected by IPC specialists and further cemented their belief in the need for an engaging intervention that could improve compliance with COVID-19 safe behaviors. Objective Our aim was to develop a serious game that would promote IPC practices with a specific focus on COVID-19 among HCWs and other hospital employees. Methods The first 3 stages of the SERES framework were used to develop this serious game. A brainswarming session between developers and IPC specialists was used to identify the target audience and acquisition objectives. Nicholson’s RECIPE mnemonic (reflection, engagement, choice, information, play, exposition) for meaningful gamification was used to guide the general design. A common and simple terminology was used to suit the broad target audience. The game was tested on various platforms (smartphones, tablets, laptops, desktop computers) by different users during each development loop and before its final release. Results The game was designed to target all hospital staff who could be in direct contact with patients within the Geneva University Hospitals. In total, 10 acquisition objectives were defined by IPC specialists and implemented into the game according to the principles of meaningful gamification. A simple storyboard was first created using Microsoft PowerPoint and was progressively refined through multiple iteration loops. Articulate Storyline was then used to create two successive versions of the actual game. In the final version, a unique graphic atmosphere was created with help from a professional graphic designer. Feedback mechanisms were used extensively throughout the game to strengthen key IPC messages. Conclusions The SERES framework was successfully used to create “Escape COVID-19,” a serious game designed to promote safe IPC practices among HCWs and other hospital employees during the COVID-19 pandemic. This game can be obtained free of charge for research and educational purposes. A SCORM (shareable content object reference model) package is available to facilitate results and completion tracking on most current learning management systems.

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Does pre-testing promote better retention than post-testing?

Cited by 38 publications

References 32 publications

Effect of an E-Learning Module on Personal Protective Equipment Proficiency Among Prehospital Personnel: Web-Based Randomized Controlled Trial

Effect of an E-Learning Module on Personal Protective Equipment Proficiency Among Prehospital Personnel: Web-Based Randomized Controlled Trial

Impact of an e-learning module on personal protective equipment knowledge in student paramedics: a randomized controlled trial

A Serious Game Designed to Promote Safe Behaviors Among Health Care Workers During the COVID-19 Pandemic: Development of “Escape COVID-19”

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