• multicentre study [publication type];
  • randomised controlled trial [publication type];
  • *Internet;
  • *education, distance;
  • crossover studies;
  • *cognition;
  • clinical competence/*standards;
  • learning;
  • education, medical/*methods;
  • United States

Context  Adapting web-based (WB) instruction to learners' individual differences may enhance learning.

Objectives  This study aimed to investigate aptitude–treatment interactions between learning and cognitive styles and WB instructional methods.

Methods  We carried out a factorial, randomised, controlled, crossover, post-test-only trial involving 89 internal medicine residents, family practice residents and medical students at 2 US medical schools. Parallel versions of a WB course in complementary medicine used either active or reflective questions and different end-of-module review activities (‘create and study a summary table’ or ‘study an instructor-created table’). Participants were matched or mismatched to question type based on active or reflective learning style. Participants used each review activity for 1 course module (crossover design). Outcome measurements included the Index of Learning Styles, the Cognitive Styles Analysis test, knowledge post-test, course rating and preference.

Results  Post-test scores were similar for matched (mean ± standard error of the mean 77.4 ± 1.7) and mismatched (76.9 ± 1.7) learners (95% confidence interval [CI] for difference − 4.3 to 5.2l, P = 0.84), as were course ratings (P = 0.16). Post-test scores did not differ between active-type questions (77.1 ± 2.1) and reflective-type questions (77.2 ± 1.4; P = 0.97). Post-test scores correlated with course ratings (r = 0.45). There was no difference in post-test subscores for modules completed using the ‘construct table’ format (78.1 ± 1.4) or the ‘table provided’ format (76.1 ± 1.4; CI − 1.1 to 5.0, P = 0.21), and wholist and analytic styles had no interaction (P = 0.75) or main effect (P = 0.18). There was no association between activity preference and wholist or analytic scores (P = 0.37).

Conclusions  Cognitive and learning styles had no apparent influence on learning outcomes. There were no differences in outcome between these instructional methods.