Mobile Technology in E-Learning for Undergraduate Medical Education on Emergent Otorhinolaryngology-Head and Neck Surgery Disorders: Pilot Randomized Controlled Trial

Li-Ang Lee, Shu-Ling Wang, Yi-Ping Chao, Ming-Shao Tsai, Li-Jen Hsin, Chung-Jan Kang, Chia-Hsiang Fu, Wei-Chieh Chao, Chung-Guei Huang, Hsueh-Yu Li, Cheng-Keng Chuang, Li-Ang Lee, Shu-Ling Wang, Yi-Ping Chao, Ming-Shao Tsai, Li-Jen Hsin, Chung-Jan Kang, Chia-Hsiang Fu, Wei-Chieh Chao, Chung-Guei Huang, Hsueh-Yu Li, Cheng-Keng Chuang

Abstract

Background: The use of mobile technology in e-learning (M-TEL) can add new levels of experience and significantly increase the attractiveness of e-learning in medical education. Whether an innovative interactive e-learning multimedia (IM) module or a conventional PowerPoint show (PPS) module using M-TEL to teach emergent otorhinolaryngology-head and neck surgery (ORL-HNS) disorders is feasible and efficient in undergraduate medical students is unknown.

Objective: The aim of this study was to compare the impact of a novel IM module with a conventional PPS module using M-TEL for emergent ORL-HNS disorders with regard to learning outcomes, satisfaction, and learning experience.

Methods: This pilot study was conducted at an academic teaching hospital and included 24 undergraduate medical students who were novices in ORL-HNS. The cognitive style was determined using the Group Embedded Figures Test. The participants were randomly allocated (1:1) to one of the two groups matched by age, sex, and cognitive style: the IM group and the PPS group. During the 100-min learning period, the participants were unblinded to use the IM or PPS courseware on a 7-inch tablet. Pretests and posttests using multiple-choice questions to evaluate knowledge and multimedia situational tests to evaluate competence were administered. Participants evaluated their satisfaction and learning experience by the AttrakDiff2 questionnaire, and provided feedback about the modules.

Results: Overall, the participants had significant gains in knowledge (median of percentage change 71, 95% CI 1-100, P<.001) and competence (median of percentage change 25, 95% CI 0-33, P=.007) after 100 min of learning. Although there was no significant difference in knowledge gain between the two groups (median of difference of percentage change 24, 95% CI -75 to 36; P=.55), competence gain was significantly lower in the IM group compared with the PPS group (median of difference of percentage change -41, 95% CI -67 to -20; P=.008). However, the IM group had significantly higher scores of satisfaction (difference 2, 95% CI 2-4; P=.01), pragmatic quality (difference 1.7, 95% CI 0.1-2.7; P=.03), and hedonic stimulation (difference 1.9, 95% CI 0.3-3.1; P=.01) compared with the PPS group. Qualitative feedback indicated that the various games in the IM module attracted the participants' attention but that the nonlinearly arranged materials affected their learning.

Conclusions: Using M-TEL for undergraduate medical education on emergent ORL-HNS disorders, an IM module seems to be useful for gaining knowledge, but competency may need to occur elsewhere. While the small sample size reduces the statistical power of our results, its design seems to be appropriate to determine the effects of M-TEL using a larger group.

Trial registration: ClinicalTrials.gov NCT02971735; https://ichgcp.net/clinical-trials-registry/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV).

Keywords: e-learning; gamification; mobile technology; randomized controlled trial; video lecture.

Conflict of interest statement

Conflicts of Interest: None declared.

©Li-Ang Lee, Shu-Ling Wang, Yi-Ping Chao, Ming-Shao Tsai, Li-Jen Hsin, Chung-Jan Kang, Chia-Hsiang Fu, Wei-Chieh Chao, Chung-Guei Huang, Hsueh-Yu Li, Cheng-Keng Chuang. Originally published in JMIR Medical Education (http://mededu.jmir.org), 08.03.2018.

Figures

Figure 1
Figure 1
The Consolidated Standards of Reporting Trials flow diagram of this pilot study. GEFT: Group Embedded Figures Test; IM: interactive multimedia; ORL-HNS: otorhinolaryngology–head and neck surgery; PPS: PowerPoint show.
Figure 2
Figure 2
User interface of the start screen contained four instructional domains, an adventure story and a review center.
Figure 3
Figure 3
A screenshot of the review center allowing the learners to review the acquired instruction materials anytime.
Figure 4
Figure 4
Screenshots of the PowerPoint Show module. Learners in this group needed to watch visual-auditory text-image videos including linearly arranged instructional slides (top, middle, bottom).
Figure 5
Figure 5
Screenshots of the interactive multimedia module. Learners in this group operated a character to run, jump, and interact with other characters (top) to obtain instructional materials (middle) and complete small game-based quizzes (bottom).
Figure 6
Figure 6
Gains of knowledge and competence. There was no significant difference in multiple choice (MCQ) test scores between the interactive multimedia (IM) and PowerPoint show (PPS) groups (left). The multimedia situational test (MST) score of the IM group was significantly lower than that of the PPS group (right). Data are expressed as median (95% CI). "a" indicates significance.
Figure 7
Figure 7
Satisfaction and learning experience. Global satisfaction score (GSS) of the IM group was significantly higher than that of the PowerPoint show (PPS) group (left). Using the AttrakDiff2 questionnaire, pragmatic quality (PQ) and hedonic stimulation (HQ-S) in the IM group were significantly higher than those of the PPS group. There were no significant differences in hedonic identification (HQ-I) and attractiveness (ATT) between the two groups (right). Data are expressed as median (95% CI). "a" indicates significance.

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Source: PubMed

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