Auditory Narrative Does Not Improve Learning when Added to Visual Computer-Based Learning Modules

Abstract

Computer-based learning (CBL) is considered by many to be an effective means of education. However, features of computer-based modules purported to contribute to learning have not been studied with medical student education. This study was designed to evaluate the effect of auditory supplements in a computer-based instructional module on learning and knowledge retention. A prospective, randomized controlled trial comparing the effectiveness of two types of web-based instructional presentations used to teach key aspects of systems-based practice to fourth-year medical students. The intervention and control group each received a computer-based module comprised of the same mix of visual and written material, but the intervention group also received an auditory narration of the materials. The primary outcome measures were the difference in the students' scores between the two modules using an online 8-item knowledge test completed immediately after the first exposure to the module and again 1 to 7months later. Students were also asked whether they considered themselves auditory learners. Learning efficiency (the amount of learning per unit time) was calculated for each student and the Mann-Whitney U test was used to compare scores between the two groups. One hundred thirty fourth-year medical students were randomized by a computer program to one of the two modules. All students completed the first knowledge test and 86 (66%) students completed the second test. Test scores did not differ significantly between the two groups in either the first or the second test. Learning efficiency was lower in the intervention group. Self-identification as auditory learners had no effect on performance. The addition of narration to a computer-based instructional module did not improve learning or knowledge retention even in students who self-identified as auditory learners and resulted in overall lower learning efficiency.