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Adapting Web-based Instruction to Residents’ Knowledge Improves Learning Efficiency

A Randomized Controlled Trial

  • Original Article
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Journal of General Internal Medicine Aims and scope Submit manuscript

Summary

BACKGROUND

Increased clinical demands and decreased available time accentuate the need for efficient learning in postgraduate medical training. Adapting Web-based learning (WBL) to learners’ prior knowledge may improve efficiency.

OBJECTIVE

We hypothesized that time spent learning would be shorter and test scores not adversely affected for residents who used a WBL intervention that adapted to prior knowledge.

DESIGN

Randomized, crossover trial.

SETTING

Academic internal medicine residency program continuity clinic.

PARTICIPANTS

122 internal medicine residents.

INTERVENTIONS

Four WBL modules on ambulatory medicine were developed in standard and adaptive formats. The adaptive format allowed learners who correctly answered case-based questions to skip the corresponding content.

MEASUREMENTS and Main Results

The measurements were knowledge posttest, time spent on modules, and format preference. One hundred twenty-two residents completed at least 1 module, and 111 completed all 4. Knowledge scores were similar between the adaptive format (mean ± standard error of the mean, 76.2 ± 0.9) and standard (77.2 ± 0.9, 95% confidence interval [CI] for difference −3.0 to 1.0, P = .34). However, time spent was lower for the adaptive format (29.3 minutes [CI 26.0 to 33.0] per module) than for the standard (35.6 [31.6 to 40.3]), an 18% decrease in time (CI 9 to 26%, P = .0003). Seventy-two of 96 respondents (75%) preferred the adaptive format.

CONCLUSIONS

Adapting WBL to learners’ prior knowledge can reduce learning time without adversely affecting knowledge scores, suggesting greater learning efficiency. In an era where reduced duty hours and growing clinical demands on trainees and faculty limit the time available for learning, such efficiencies will be increasingly important. For clinical trial registration, see http://www.clinicaltrials.gov NCT00466453 (http://www.clinicaltrials.gov/ct/show/NCT00466453?order=1).

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ACKNOWLEDGMENTS

We thank V. Shane Pankratz, Ph.D., for assistance with statistical analyses, and K. Sorensen for assistance in developing the modules. An abstract based on this work was presented at the 2007 meeting of the Association for Medical Education in Europe in Trondheim, Norway. The funding source was the Mayo Education Innovation Program.

Conflicts of Interest Statement

None disclosed.

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Authors and Affiliations

  1. Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA

    David A. Cook MD, MHPE & Thomas J. Beckman MD

  2. Division of Primary Care Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA

    Kris G. Thomas MD

  3. Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA

    Warren G. Thompson MD

Authors
  1. David A. Cook MD, MHPE
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  2. Thomas J. Beckman MD
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  3. Kris G. Thomas MD
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  4. Warren G. Thompson MD
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Corresponding author

Correspondence to David A. Cook MD, MHPE.

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Cook, D.A., Beckman, T.J., Thomas, K.G. et al. Adapting Web-based Instruction to Residents’ Knowledge Improves Learning Efficiency. J GEN INTERN MED 23, 985–990 (2008). https://doi.org/10.1007/s11606-008-0541-0

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  • DOI: https://doi.org/10.1007/s11606-008-0541-0

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