Effectiveness of discovery learning using a mobile otoscopy simulator on knowledge acquisition and retention in medical students: a randomized controlled trial

Abstract

BackgroundPortable educational technologies, like simulators, afford students the opportunity to learn independently. A key question in education, is how to pair self-regulated learning (SRL) with direct instruction. A cloud-based portable otoscopy simulator was employed to compare two curricula involving SRL. Pre-clerkship medical students used a prototype smartphone application, a 3D ear attachment and an otoscope to complete either otoscopy curriculum.MethodsPre-clerkship medical students were recruited and randomized to two curriculum designs. The “Discovery then Instruction” group received the simulator one week before a traditional lecture, while the “Instruction then Discovery” group received it after the lecture. To assess participants’ ability to identify otoscopic pathology, we used a 100-item test at baseline, post-intervention and 2-week retention time points. Secondary outcomes included self-reported comfort, time spent using the device, and a survey on learning preferences.ResultsThirty-four students completed the study. Analysis of knowledge acquisition and retention showed improvement in scores of both groups and no significant effects of group (F1,31 = 0.53, p = 0.47). An analysis of participants’ self-reported comfort showed a significant group x test interaction (F1,36 = 4.61, p = 0.04), where only the discovery then instruction group’s comfort improved significantly. Overall device usage was low, as the discovery then instruction group spent 21.47 ± 26.28 min, while the instruction then discovery group spent 13.84 ± 18.71 min. The discovery first group’s time spent with the simulator correlated moderately with their post-test score (r = 0.42, p = 0.07). After the intervention, most participants in both groups (63–68%) stated that they would prefer the instruction then discovery sequence.ConclusionsBoth curricular sequences led to improved knowledge scores with no statistically significant knowledge differences. When given minimal guidance, students engaged in discovery learning minimally. There is value in SRL in simulation education, and we plan to further improve our curricular design by considering learner behaviours identified in this study.

Design, Validity and Effect of an Intra-Curricular Program for Facilitating Self-Regulation of Learning Competences in University Students with the Support of the 4Planning App

“…Smartphones have brought massive changes to people's lives, allowing, in the case of students, easy access to information, diverse social communications and learning possibilities [45]. Portable educational technologies, such as simulators, provide students with the opportunity to learn independently [48]. As we have highlighted above, given that students use and carry their smartphones every day, and their behaviors are reflected in their smartphone use, it is important to explore ways to support self-regulation through smartphones [45].…”

Self-Regulated Learning and Academic Performance in Chilean University Students in Virtual Mode During the Pandemic: Effect of the 4Planning App

“…Given that smartphone, tablet, or computer apps are easily accessible and everyday tools, especially by students (Kortabitarte et al, 2018;Hartley et al, 2020), studies have identified that using smartphones in the service of learning generates positive academic outcomes (Anshari et al, 2017;Nguyen et al, 2018;Ariel and Elishar-Malka, 2019;Dalvi-Esfahani et al, 2020) and that using them for non-academic purposes (e.g., to check virtual social networks) burdens students' cognitive resource management by being a source of distraction when studying and when performing academic tasks outside of class (May and Elder, 2018;Aharony and Zion, 2019), which is associated with lower academic performance (Lepp et al, 2015;Chen and Yan, 2016). A small, recent body of research evaluates the impact of asking students to self-regulate their learning using apps (Xu et al, 2018;Foerst et al, 2019;Hendikawati et al, 2019;Kim et al, 2019;Loeffler et al, 2019;Broadbent et al, 2020;Hartley et al, 2020). Lobos et al (2021a) used the self-regulation of learning model proposed by Zimmerman (2002) to design the 4Planning app for smartphone, with the aim of evaluating its impact on the SRL of 473 1st-year engineering students in face-to-face mode, belonging to seven Chilean universities, during the first semester of 2019.…”

“…As part of their research, Lobos et al (2021a) systematically reviewed interventions that promoted SRL in college students using smartphones. While the seven studies they identified consider academic performance in argumentation, only two incorporated it as a dependent variable in their models (Xu et al, 2018;Hartley et al, 2020), but the proposed interventions did not generate a statistically significant impact. In addition, there is only one study of the effect of the 4Planning app on SRL, in a sample of engineering students, in face-to-face modality, without pandemic, and also did not consider performance as a dependent variable (Lobos et al, 2021a).…”

Endoscopic ear examination improves self-reported confidence in ear examination skills among undergraduate medical students compared with handheld otoscopy

“…One main goal of medical education is to fulfil the educational needs of the student. We conclude that students should be trained in their preferred examination methods to achieve the highest levels of confidence and skill, especially in the age of self-regulated learning and student-centered medical education [ 19 ]. We thus propose taking into consideration the students’ own support for teaching endoscopic ear examination in the future.…”