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

doi:10.2196/mededu.9237

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

JMIR Med Educ. 2018 Mar 8;4(1):e8. doi: 10.2196/mededu.9237.

Authors

Li-Ang Lee^{1

2

3}, Shu-Ling Wang^{2

4}, Yi-Ping Chao^{5

6}, Ming-Shao Tsai^{1

7}, Li-Jen Hsin^{1

3}, Chung-Jan Kang^{1

3}, Chia-Hsiang Fu^{1

3}, Wei-Chieh Chao^{1

8}, Chung-Guei Huang^{9

10}, Hsueh-Yu Li^{1

3}, Cheng-Keng Chuang^#^{1

2

11}

Affiliations

¹ Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan.
² Graduate Institute of Clinical Medicine Sciences, Chang Gung University, Taoyuan, Taiwan.
³ Department of Otorhinolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
⁴ Graduate Institute of Digital Learning and Education, National Taiwan University of Science and Technology, Taipei, Taiwan.
⁵ Graduate Institute of Medical Mechatronics, Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan.
⁶ Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
⁷ Department of Otorhinolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁸ Department of Otorhinolaryngology-Head and Neck Surgery, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
⁹ Department of Laboratory Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
¹⁰ Graduate Institute of Biomedical Sciences, Department of Medical Biotechnology and Laboratory Science, Chang-Gung University, Taoyuan, Taiwan.
¹¹ Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.

^# Contributed equally.

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://clinicaltrials.gov/ct2/show/NCT02971735 (Archived by WebCite at http://www.webcitation.org/6waoOpCEV).

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

©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.

Associated data

ClinicalTrials.gov/NCT02971735