Learning How to Order Imaging Tests and Make Subsequent Clinical Decisions: a Randomized Study of the Effectiveness of a Virtual Learning Environment for Medical Students

Med Sci Educ. 2021 Jan 11;31(2):469-477. doi: 10.1007/s40670-020-01188-5. eCollection 2021 Apr.

Abstract

Rationale and objectives: Two critical skills that medical students must acquire during undergraduate education are the ability to order imaging tests and make clinical decisions based on their results. We implemented an e-learning course in Moodle specifically designed to teach these skills to medical students. The aim of this study was to assess the effectiveness of our course.

Material and methods: We randomized 26 undergraduate medical students to an experimental group that had access to the virtual learning environment and a control group that did not. Three weeks after the course, we evaluated its effectiveness through a blinded objective structured clinical examination. To avoid any bias in favor of the experimental group, the assessment considered scores on two pre-specified subscales: one related to the contents of the course and the other to new clinical scenarios.

Results: Students that completed the e-course performed better overall than controls (mean score ± standard deviation 59.3 ± 6.2 vs 41.8 ± 10.2, p = 0.0020). This better performance was observed in both types of skills assessed (ordering imaging tests, and making diagnostic and therapeutic decisions based on test results). More importantly, this better performance of the experimental group was observed consistently both with items related to the course content (1.7 times higher, p = 0.0034) and new scenarios (1.3 times higher, p = 0.0098).

Conclusions: Through an ad - hoc e-course, undergraduate medical students learned effectively how to order imaging tests and make optimal subsequent decisions. Moreover, they were able to apply these skills to new clinical scenarios.

Keywords: Clinical decision-making; Medical education; Online education; Randomized controlled trial.