E-learning optimization: the relative and combined effects of mental practice and modeling on enhanced podcast-based learning—a randomized controlled trial
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Enhanced podcasts increase learning, but evidence is lacking on how they should be designed to optimize their effectiveness. This study assessed the impact two learning instructional design methods (mental practice and modeling), either on their own or in combination, for teaching complex cognitive medical content when incorporated into enhanced podcasts. Sixty-three medical students were randomised to one of four versions of an airway management enhanced podcast: (1) control: narrated presentation; (2) modeling: narration with video demonstration of skills; (3) mental practice: narrated presentation with guided mental practice; (4) combined: modeling and mental practice. One week later, students managed a manikin-based simulated airway crisis. Knowledge acquisition was assessed by baseline and retention multiple-choice quizzes. Two blinded raters assessed all videos obtained from simulated crises to measure the students’ skills using a key-elements scale, critical error checklist, and the Ottawa global rating scale (GRS). Baseline knowledge was not different between all four groups (p = 0.65). One week later, knowledge retention was significantly higher for (1) both the mental practice and modeling group than the control group (p = 0.01; p = 0.01, respectively) and (2) the combined mental practice and modeling group compared to all other groups (all ps = 0.01). Regarding skills acquisition, the control group significantly under-performed in comparison to all other groups on the key-events scale (all ps ≤ 0.05), the critical error checklist (all ps ≤ 0.05), and the Ottawa GRS (all ps ≤ 0.05). The combination of mental practice and modeling led to greater improvement on the key events checklist (p = 0.01) compared to either strategy alone. However, the combination of the two strategies did not result in any further learning gains on the two other measures of clinical performance (all ps > 0.05). The effectiveness of enhanced podcasts for knowledge retention and clinical skill acquisition is increased with either mental practice or modeling. The combination of mental practice and modeling had synergistic effects on knowledge retention, but conveyed less clear advantages in its application through clinical skills.
KeywordsCurriculum design E-learning Instructional design Learning strategies Medical education Mental practice Modeling Mobile learning Podcasts Simulation
The authors thank Roger Chow and Agnes Ryzynski for their great support in the data collection for this study. They have both given written confirmation for this acknowledgement.
This work was supported by: (1) Education Initiatives in Residency Education Grant (EIRE)—Faculty of Medicine, University of Ottawa, Ottawa, Canada: Funds were used for data collection, specifically to purchase technological equipment such as Apple iPads. Funds were used to cover expenses incurred presenting preliminary results at the annual Association for Medical Education (AMEE) conference in August 2012. (2) Allan Waters Patient Family Simulation Centre, St. Michael’s Hospital, Toronto, Canada, and the Anaesthesia Departments at The University of Toronto, Toronto, Canada and the University of Ottawa, Ottawa, Canada.: Funds provided were used for data collection, specifically for simulation time only.
FA: Study design, conduct, recruitment, data collection, management, analysis and interpretation, first draft of manuscript and subsequent edits. SB: Study design, analysis and interpretation, and manuscript edits. DP: Study design, and manuscript edits. AL: Rating videos and manuscript edits. CP: Rating videos and manuscript edits. VL: Study design, analysis and interpretation, and manuscript edits.
Compliance with ethical standards
Conflict of interests
None of the authors have any interests to declare.
- Allen, K. L., & Katz, R. V. (2011). Comparative use of podcasts vs. lecture transcripts as learning aids for dental students. Journal of dental education, 75(6), 817–822.Google Scholar
- Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Upper Saddle River: Prentice Hall.Google Scholar
- Bhatti, I., Jones, K., Richardson, L., Foreman, D., Lund, J., & Tierney, G. (2011). E-learning vs lecture: which is the best approach to surgical teaching? Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 13(4), 459–462. doi:10.1111/j.1463-1318.2009.02173.x.CrossRefGoogle Scholar
- Cobcroft, R. S., Towers, S. J., Smith, J. E., & Bruns, A. (2006). Mobile learning in review: Opportunities and challenges for learners, teachers, and institutions. Creative Industries Faculty.Google Scholar
- Cohen, J. (1988). Statistical power analysis for the behavioral sciencies (2nd ed.). New York: Lawrence Erlbaum.Google Scholar
- Cook, D. A., Hatala, R., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., et al. (2011). Technology-enhanced simulation for health professions education: A systematic review and meta-analysis. JAMA: the Journal of the American Medical Association, 306(9), 978–988. doi:10.1001/jama.2011.1234.CrossRefGoogle Scholar
- Cook, D. A., Levinson, A. J., Garside, S., Dupras, D. M., Erwin, P. J., & Montori, V. M. (2010). Instructional design variations in internet-based learning for health professions education: A systematic review and meta-analysis. Academic Medicine: Journal of the Association of American Medical Colleges, 85(5), 909–922. doi:10.1097/ACM.0b013e3181d6c319.CrossRefGoogle Scholar
- Custers, E., Regehr, G., McCulloch, W., Peniston, C., & Reznick, R. (1999). The effects of modeling on learning a simple surgical procedure: See one, do one or see many, do one? Advances in Health Sciences Education: Theory and Practice, 4(2), 123–143. doi:10.1023/A:1009763210212.CrossRefGoogle Scholar
- Feltz, D. L., & Landers, D. M. (1983). The effects of mental practice on motor skill learning and performance: A meta-analysis. Journal of Sport Psychology; Journal of …, 5(1), 25–27.Google Scholar
- Feltz, D. L., Landers, D. M., & Becker, B. J. (1988). A revised meta-analysis of the mental practice literature on motor skill learning. Washington, DC: National Academy Press. http://www.nap.edu/openbook.php?record_id=782&page=R1.
- Fernandez, V., Sallan, J. M., & Simo, P. (2014). Past, present, and future of podcasting in higher education. In M. Li & Y. Zhao (Eds.), Exploring Learning & Teaching in Higher Education (pp. 305–330). Berlin, Heidelberg: Springer. doi:10.1007/978-3-642-55352-3_14.
- Fryling, M. J., Johnston, C., & Hayes, L. J. (2011). Understanding observational learning: An interbehavioral approach. The Analysis of Verbal Behavior, 27(1), 191.Google Scholar
- Glisky, M., Williams, J., & Kihlstrom, J. (1996). Internal and external mental imagery perspectives and performance on two tasks. Journal of Sport Behaviour, 19(1), 3.Google Scholar
- Kim, J. J., Neilipovitz, D. D., Cardinal, P. P., Chiu, M. M., & Clinch, J. J. (2006). A pilot study using high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: The University of Ottawa Critical Care Medicine, High-Fidelity Simulation, and Crisis Resource Management I Study. Critical Care Medicine, 34(8), 2167–2174. doi:10.1097/01.CCM.0000229877.45125.CC.CrossRefGoogle Scholar
- Li, N., Kidziński, Ł., Jermann, P., & Dillenbourg, P. (2015). MOOC video interaction patterns: What do they tell us? In G. Conole, T. Klobuèar, C. Rensing, J. Konert, É. Lavoué (Eds.), Design for teaching and … (Vol. 9307, pp. 197–210). Cham: Springer International Publishing. doi:10.1007/978-3-319-24258-3_15.
- McCullagh, P., & Weiss, M. R. (2001). Modeling: Considerations for motor skill performance and psychological responses. Handbook of Sport Psychology, 92, 977–984.Google Scholar
- Morgan, G. E., Mikhail, M. S., & Murray, M. J. (2006). Clinical anesthesiology (4th ed.). New York: Lange Medical Books/McGraw-Hill.Google Scholar
- Nast, A., Schäfer-Hesterberg, G., Zielke, H., Sterry, W., & Rzany, B. (2009). Online lectures for students in dermatology: A replacement for traditional teaching or a valuable addition? Journal of the European Academy of Dermatology and Venereology, 23(9), 1039–1043. doi:10.1111/j.1468-3083.2009.03246.x.CrossRefGoogle Scholar
- NUS/HEFCE (2010) Student perspectives on technology – demand, perceptions and training needs. Report to HEFCE by NUS, England. Available at http://www.hefce.ac.uk/pubs/rdreports/2010/rd18_10/rd18_10.pdf.
- Sanders, C. W. C., Sadoski, M. M., Bramson, R. R., Wiprud, R. R., & Van Walsum, K. K. (2004). Comparing the effects of physical practice and mental imagery rehearsal on learning basic surgical skills by medical students. American Journal of Obstetrics and Gynecology, 191(5), 1811–1814. doi:10.1016/j.ajog.2004.07.075.CrossRefGoogle Scholar
- Spiro, R. J., Feltovich, P. J., & Jacobson, M. J. (1992). Cognitive flexibility, constructivism, and hypertext: Random access instruction for advanced knowledge acquisition in ill-structured domains. Constructivism and the Technology of Instruction.Google Scholar
- Welk, A., Immenroth, M., Sakic, P., Bernhardt, O., Eberspächer, H. H., & Meyer, G. (2007). Mental training in dentistry. Quintessence International (Berlin, Germany: 1985), 38(6), 489–497.Google Scholar