Editors' Note: Teaching the Neurologic Examination: A Prospective Controlled Study to Compare a Blended Learning Approach With Face-to-Face Instruction

Abstract

In a prospective controlled study of 163 fourth-year medical students, Dr. Bornkamm et al. compared the effectiveness of a blended learning approach—consisting of individual preparation with a course handbook and video clips followed by a single face-to-face session—with traditional instruction consisting of 2 face-to-face sessions. Students in the blended learning group achieved better acquisition of neurologic examination skills as assessed by an objective structured clinical examination (OSCE) and reported a higher level of satisfaction, with this method providing more time for practice and feedback. In response, Dr. Jozefowicz contends that the mean difference in OSCE scores between the groups was quite small and that the better satisfaction scores in the blended learning group might be explained by the novelty effect. Dr. Josefowicz also notes that although blended learning may save faculty teaching time, it also requires additional upfront time to prepare videos. Responding to these comments, the authors agree that the superiority of blended learning to traditional approaches is not settled. However, they emphasize that the blended approach is a comparable and useful alternative which allows successful skill acquisition despite reduced face-to-face attendance time, with key advantages including greater standardization of examination techniques, opportunities for individualized learning, and more time for practice and feedback during in-person sessions, and therefore deserves consideration as part of a combined, customized approach to medical education. They also suggest that setting up a network for neuroeducational resources could reduce the workload involved in teaching video preparation. This exchange highlights the ongoing debate in medical education regarding the relative merits and costs of different configurations of e-learning and face-to-face approaches. It also emphasizes the potential benefit of sharing teaching resources across institutions. In a prospective controlled study of 163 fourth-year medical students, Dr. Bornkamm et al. compared the effectiveness of a blended learning approach—consisting of individual preparation with a course handbook and video clips followed by a single face-to-face session—with traditional instruction consisting of 2 face-to-face sessions. Students in the blended learning group achieved better acquisition of neurologic examination skills as assessed by an objective structured clinical examination (OSCE) and reported a higher level of satisfaction, with this method providing more time for practice and feedback. In response, Dr. Jozefowicz contends that the mean difference in OSCE scores between the groups was quite small and that the better satisfaction scores in the blended learning group might be explained by the novelty effect. Dr. Josefowicz also notes that although blended learning may save faculty teaching time, it also requires additional upfront time to prepare videos. Responding to these comments, the authors agree that the superiority of blended learning to traditional approaches is not settled. However, they emphasize that the blended approach is a comparable and useful alternative which allows successful skill acquisition despite reduced face-to-face attendance time, with key advantages including greater standardization of examination techniques, opportunities for individualized learning, and more time for practice and feedback during in-person sessions, and therefore deserves consideration as part of a combined, customized approach to medical education. They also suggest that setting up a network for neuroeducational resources could reduce the workload involved in teaching video preparation. This exchange highlights the ongoing debate in medical education regarding the relative merits and costs of different configurations of e-learning and face-to-face approaches. It also emphasizes the potential benefit of sharing teaching resources across institutions.