Abstract
Medical Education can be delivered in the traditional classroom or via novel technology including an online classroom. To test the hypothesis that learning in an online classroom would result in similar outcomes as learning in the traditional classroom when using a flipped classroom pedagogy. Randomized controlled trial. A total of 274 subjects enrolled in a Neuro-otology training program for non-Neuro-otologists of 25 h held over a 3-day period. Subjects were randomized into a "control" group attending a traditional classroom and a "trial" group of equal numbers participating in an online synchronous Internet streaming classroom using the Adobe Connect e-learning platform. Subjects were randomized into a "control" group attending a traditional classroom and a "treatment" group of equal numbers participating in an online synchronous Internet streaming classroom. Pre- and post-multiple choice examinations of VOR, Movement, Head Turns, Head Tremor, Neurodegeneration, Inferior Olivary Complex, Collateral Projections, Eye Movement Training, Visual Saccades, Head Saccades, Visual Impairment, Walking Speed, Neuroprotection, Autophagy, Hyperkinetic Movement, Eye and Head Stability, Oscilllatory Head Movements, Gaze Stability, Leaky Neural Integrator, Cervical Dystonia, INC and Head Tilts, Visual Pursuits, Optokinetic Stimulation, and Vestibular Rehabilitation. All candidates took a pretest examination of the subject material. The 2-9 h and 1-8 h sessions over three consecutive days were given live in the classroom and synchronously in the online classroom using the Adobe Connect e-learning platform. Subjects randomized to the online classroom attended the lectures in a location of their choice and viewed the sessions live on the Internet. A posttest examination was given to all candidates after completion of the course. Two sample unpaired t tests with equal variances were calculated for all pretests and posttests for all groups including gender differences. All 274 subjects demonstrated statistically significant learning by comparison of their pre- and posttest scores. There were no statistically significant differences in the test scores between the two groups of 137 subjects each (0.8%, 95% CI 85.45917-86.67952; P = 0.9195). A total of 101 males in the traditional classroom arm had statistically significant lower scores than 72 females (0.8%, 95% CI 84.65716-86.53096; P = 0.0377) but not in the online arm (0.8%, 95% CI 85.46172-87.23135; P = 0.2176) with a moderate effect size (Cohen's d = -0.407). The use of a synchronous online classroom in neuro-otology clinical training has demonstrated similar outcomes to the traditional classroom. The online classroom is a low cost and effective complement to medical specialty training in Neuro-Otology. The significant difference in outcomes between males and females who attended the traditional classroom suggests that women may do better than males in this learning environment, although the effect size is moderate. Clinicaltrials.gov, identifier NCT03079349.
Highlights
The increasing availability of online learning has increased the ability of medical students, residents, fellows, and practicing physicians to learn at a distance
The online learning environment should be contemporary in order to adequately present medical education and to contribute clarity to comparisons of learning environment
We wanted to identify any differences in gender in medical education because of interest we have specific to gender bias in society
Summary
The increasing availability of online learning has increased the ability of medical students, residents, fellows, and practicing physicians to learn at a distance. The online learning environment should be contemporary in order to adequately present medical education and to contribute clarity to comparisons of learning environment. We needed to develop a methodology of instruction that is evidence based and current in order to test our hypothesis that there is no difference in learning associated with a traditional classroom and a synchronous online classroom experience. There are large numbers of educational platforms commercially available, and we had a need to review and understand screencasting best practices in order to develop a screencasting platform. In 2014, Andrew Youngkin described the benefits of screencasting in health professional education (1). Such benefits included the enhancement of demonstrations, facilitation of collaborative activities, encouragement of communication, and the evaluation of learning/understanding. Youngkin noted the use of the “flipped classroom” to improve efficiency in curriculum delivery and foster in-depth class discussion and collaborative problem solving
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