Development of an undergraduate curriculum in obstetrical simulation

Abstract

algorithm that customises the spacing and content of subsequent questions in order to maximise knowledge acquisition and retention for each learner. As a stand-alone educational intervention, spaced education has been shown in randomised trials to increase knowledge acquisition, boost learning retention and improve clinical behaviour. Why the idea was necessary A recent report by the US Department of Education found that online education which is blended with live courses is more effective than online educational interventions alone. It is not clear how spaced education can best be ‘blended’ with traditional forms of medical education to improve its efficacy and acceptability. We conducted a pilot study to determine whether spaced education can be an effective supplement to a live lecture-based continuing medical education (CME) course. What was done Attendees of the Harvard Medical School Update in Internal Medicine course, held in Boston, MA in December 2008, were recruited via e-mail. The spaced education programme began at the close of the programme in December 2008 and ran to May 2009. The programme consisted of 12 questions on hepatitis C, which was the topic of a featured lecture during the course. The 12-item adaptive spaced education course was structured so that learners were sent two questions every 2 days. If a question was answered incorrectly, it was repeated 12 days later. If a question was answered correctly, it was repeated 24 days later. Once a question had been answered correctly twice in a row, it was retired and not repeated again. Participants completed the programme by retiring 80% of the questions and, upon doing so, were asked to complete an endof-programme evaluation using 5-point Likert scales. Evaluation of results and impact A total of 86 attendees enrolled in the trial, 15 of whom (17%) did not answer any questions. Of the remaining 71 participants, 47 (66%) completed the programme and 42 of these (89%) submitted the endof-programme evaluation. Respondents reported that: (i) the programme enhanced the impact of the live CME course (90% strongly agree ⁄ agree); (ii) they would recommend the spaced education programme to a colleague (85%); (iii) the programme reinforced their knowledge of hepatitis C (91%), and (iv) the programme increased their confidence in managing patients with hepatitis C (81%). Forty-one of 42 respondents (98%) requested to participate in further spaced education programmes offered as supplements to live CME courses. In summary, our study demonstrates that online spaced education is an effective and well-accepted supplement to a live CME course. Further research is needed to determine if spaced education can boost the ability of live CME courses to improve clinical practice patterns.