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Randomized Controlled Trial
. 2021 Jul 21;21(1):390.
doi: 10.1186/s12909-021-02822-5.

A three-arm single blind randomised control trial of naïve medical students performing a shoulder joint clinical examination

P E Brewer  1   2 , M Racy  3 , M Hampton  3 , F Mushtaq  4 , J E Tomlinson  3   5 , F M Ali  5   6
Affiliations
Randomized Controlled Trial

A three-arm single blind randomised control trial of naïve medical students performing a shoulder joint clinical examination

P E Brewer et al. BMC Med Educ. .

Abstract

Background: Technological advances have previously been hailed as a new dawn in Higher Education, with the advent of 'massive open online courses' (MOOCs) and online learning. Virtual platforms have potential advantages such as accessibility and availability but simply transferring educational material to the online environment may not ensure high quality learning. Clinical examination is a fundamental principle of medical assessment, and this study aimed to assess the role of technology in teaching these skills.

Aims/objectives: To determine whether three teaching modalities were of equal efficacy in teaching examination of the shoulder joint to naïve medical students.

Methods: Sixty-seven pre-clinical medical students naïve to large joint examination were recruited. Participants completed a learning style questionnaire and were then block randomised to three study: textbook study, face-to-face seminar, or video tutorial via online platform. The same examination technique was taught in all groups, with the intervention being the method of delivery All second year students were eligible for inclusion. The single exclusion criteria was previous exposure to clinical examination teaching. Students were assessed using a standardised scoring system at baseline (pre-intervention), and days 5 and 19 post-intervention (maximum score 30). Assessors were blinded to group allocation. The primary outcome was assessment score at day 5 post intervention.

Results: There was no difference between the three groups at baseline assessment (mean scores 2.4 for textbook, 2.8 for face-to-face, and 3.1 for video; p = 0.267). Mean post-intervention scores were 16.5 textbook, 25.5 face-to-face, and 22.4 video (p < 0.001, η2 = .449). There was no change between day 5 and day 19 post-intervention assessment scores in any group (p = 0.373), Preferred learning style did not affect scores (p = 0.543).

Conclusion: Face-to-face teaching was the most effective method for teaching clinical examination of the shoulder. Technology can potentially increase accessibility and remove geographic barriers, but is not as effective if teaching techniques are simply mirrored in an online format. Online platforms allow in depth data analysis of how learners interact with educational material and this may have value in improving the design of online educational materials, and is a potential area for further research.

Keywords: Distance learning; Medical education; Physical examination; Teaching; Technology.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Fig. 1
Fig. 1
Consort trial flow diagram showing recruitment and retention into the trial
Fig. 2
Fig. 2
Average performance improvement across Training groups. The error bars represent 95% confidence intervals and each square indicates an individual participant’s average performance across Assessment and Retention
See this image and copyright information in PMC

References

    1. Danielson AR, Venugopal S, Mefford JM, Clarke SO. How do novices learn physical examination skills? A systematic review of the literature. Med Educ Online. 2019;24(1):1608142. doi: 10.1080/10872981.2019.1608142. - DOI - PMC - PubMed
    1. Craige E. Should auscultation be rehabilitated? N Engl J Med. 1988;318(24):1611–1613. doi: 10.1056/NEJM198806163182409. - DOI - PubMed
    1. Buja LM. Medical education today: all that glitters is not gold. BMC Med Educ. 2019;19(1):110. doi: 10.1186/s12909-019-1535-9. - DOI - PMC - PubMed
    1. Jones F, Passos-Neto CE, Freitas Melro Braghiroli O. Simulation in medical education: brief history and methodology. Princ Pract Clin Res. 2015;1(2):46–54.
    1. Issenberg SB, Felner JM, Brown DD. Cardiac auscultation skills of physicians in training. JAMA. 1997;278(21):1740–1741. doi: 10.1001/jama.1997.03550210038026. - DOI - PubMed

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