Computer-assisted teaching of epistaxis management

A Randomized Controlled Trial

Authors

  • Jordan T. Glicksman BSc,

    1. Department of Otolaryngology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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  • Michael G. Brandt MD,

    1. Department of Otolaryngology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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  • Roger V. Moukarbel MD,

    1. Department of Otolaryngology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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  • Brian Rotenberg MD, FRCS (C),

    1. Department of Otolaryngology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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  • Dr. Kevin Fung MD, FRCS (C), FACS

    Corresponding author
    1. Department of Otolaryngology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
    • Victoria Hospital, Department of Otolaryngology and Reconstructive Surgery, Room C3-100, 800 Commissioners Road East, London, ON, Canada, N6A 5W9
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  • This research was funded by the Faculty Support for Research in Education Grants, University of Western Ontario; Summer Research Training Program, University of Western Ontario; and the Canadian Institute of Health Research (CIHR) Health Professional Student Research Award.

Abstract

Objectives:

To determine whether computer-assisted learning (CAL) is an effective tool for the instruction of technical skills.

Study Design:

Prospective blinded randomized-control trial conducted on a cohort of 47 first-year medical students.

Methods:

Students were instructed on two techniques of nasal packing (formal nasal pack and nasal tampon) for the management of epistaxis, using either a standard text-based article or a novel computer-based learning module. Students were evaluated on proper nasal packing technique using standardized subjective and objective outcome measures by three board-certified otolaryngologists. Blind assessments took place prior to and following instruction, using the assigned learning modality.

Results:

There were 47 participants enrolled in the study. Both groups demonstrated improvement in performance of both packing procedures following training. A significant post-training difference favoring CAL learners over text-based learners was observed, using the global assessment of skill for both packing techniques (P < .001). Additionally, a significant post-training difference favoring CAL learners over text-based learners was observed for all checklist items for the tampon pack and five of eight items on the formal pack checklist. The vast majority of students (94.6%) indicated that if given the choice, they would prefer to learn using CAL rather than by using text-based learning materials.

Conclusions:

CAL learners demonstrated significantly greater improvement across both subjective and objective outcome measures when compared to the text-based group. Additionally, students favored learning via the CAL modality, which further suggests that CAL is a valuable means of imparting procedural knowledge to novice medical trainees. Laryngoscope, 119:466–472, 2009

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