Handout Group Research Articles

Multimedia tablet or paper handout to supplement counseling during preterm birth hospitalization.

Parents of premature infants engage in shared decision-making regarding the care of their infant. The process of prenatal counseling typically involves a verbal conversation with a neonatal provider during hospitalization. Support people may not be available, and the pregnant person's memory is impaired by medications, pain, and stress. The American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development have called for improvements to this process, including the development of educational aids. This study aimed to investigate whether a multimedia tablet would be more effective than a paper handout in supplementing verbal clinician counseling during preterm birth hospitalization. This was a randomized controlled trial including English-speaking pregnant people aged ≥18 years and hospitalized at 22 to 33 weeks' gestation for preterm birth. Exclusion criteria were known fetal or chromosomal anomaly and delivery before study completion. Pregnant people received either a multimedia tablet or a paper handout before verbal clinician counseling. Preintervention assessment included demographics and State-Trait Anxiety Inventory, and postintervention assessment included the Parent Knowledge of Premature Birth Questionnaire and State-Trait Anxiety Inventory. Continuous variables were analyzed by t-test and categorical variables by Fisher exact test. A total of 122 pregnant people referred for counseling were screened; 76 were randomized, and 59 completed the study. Demographics were similar between groups, except that pregnant people in the handout group were older (mean 32 vs 29 years; P=.03). The multimedia tablet group (n=32) was less likely to report reviewing all the educational material than the paper handout group (n=27) (41% vs 72%; P=.037). Both groups correctly answered a similar number of knowledge items (P=.088). Postintervention state anxiety decreased in both groups (P<.0001), with no difference between groups. Computerized tracking showed that the multimedia group spent a median of 37 minutes reviewing the tablet. Contrary to our hypothesis, a paper handout and multimedia tablet were equally effective in the labor unit for supplementing verbal preterm birth counseling, and both decreased parental anxiety.

Patient Education on Scarring Following Mohs Micrographic Surgery: Patient Preference for Information Delivery.

There are multiple modalities for patient education ranging from written to audiovisual formats. However, little is known regarding which modality is optimal. To assess patient preference for educational materials about scar care following surgery for facial skin cancer using the FACE-Q Skin Cancer patient reported outcome measure. On the day of Mohs surgery, patients were given a written handout or viewed a 3-minute animation video regarding best practices in scar improvement. Afterward, patients received the FACE-Q Skin Cancer-Satisfaction with Information: Appearance scale. Three months later, patients were called and given the same scale and additional questions regarding scar care. A total of 75 patients were enrolled. There was no difference between the 2 groups' preoperative information scores (p = .85) and the three-month postoperative scores (p = .37). The change in preoperative and postoperative score showed no significant difference between the 2 groups (p = .21); but there was a trend of higher satisfaction in the video group on the day of Mohs surgery. After the 3-month timepoint, there was a higher satisfaction trend observed with the written handout group. Patient preferences in information delivery and accessibility will contribute to greater information retention and satisfaction.

Assessing the Effect of Restudying Anatomy with Flashcards versus Handouts in Study Groups Equalized by Memory Test Scores

IntroductionRetrieval practice through testing can strengthen long‐term memory. Experimentally, this concept known as the “testing effect” has often been demonstrated using word pairs. As many health science students quiz with flashcards to enhance recall, can the testing effect be detected within the more complex study of anatomy? It was hypothesized that participants utilizing flashcards for review would score higher on tests than those restudying a handout.MethodsStudents were recruited from Pacific Northwest University of Health Sciences (PNWU). On day 1 of the study, subjects were given 3 memory tests (assessing memory of printed words, pictures, and spoken words), the scores of which were combined and used to assign participants to groups with approximately equal “memory.” Participants studied a handout on ruminant digestive anatomy, a topic novel to most students. After the initial study session, subjects were divided into a “flashcard group” (FG) or a “handout group” (HG) and reviewed the learned material via their assigned method. Participants then took a 15‐question test, indicating whether they were confident or not for each answer, and took a similar test 1 and 3 weeks later. Participants completed surveys on demographics, existing knowledge of ruminants and anatomical terms, wellness, and study behaviors on day 1 of the study. Data were analyzed using Mann Whitney U test, Fischer’s exact test, Pearson Correlation Coefficient, and repeated measures ANOVA using SPSSv25.0 software with p&lt;0.05 considered statistically significant. This study was deemed exempt by PNWU IRB (#2021‐015).ResultsThough not statistically so, mean scores were higher in the FG than in the HG for each of the ruminant digestive anatomy assessments. For day 1 test score means (FG 10.67 ± 1.50 vs HG 9.00 ± 2.68), a large effect size (ηp2=0.16) was detected. While the FG started with more experience with anatomical terms (p=0.046), this experience was not significantly correlated with day 1 test scores (n=17). Though the FG tended to perform better on day 1 tests, the HG was more confident in their answer choices (mean confidence scores HG 10.00 ± 1.10 vs FG 7.78 ± 1.72), with a large effect size present (ηp2=0.38). Memory scores were not significantly different between the FG and the HG. Though not significant, most memory scores were negatively correlated with age. Sleep was negatively correlated with memory scores, which was significant for memory of printed words (r=‐0.56; p=0.019). Female memory scores consistently ranked higher than male scores.ConclusionsParticipants who restudied with flashcards tended to outperform those restudying handouts on tests covering a novel anatomy topic, suggesting that the testing effect may have occurred. Interestingly, the opposite pattern was seen in confidence, with those studying handouts seemingly more confident in their test answers. Utilizing memory test scores resulted in evenly distributed groups with respect to memory, and some intriguing potential differences were seen related to sleep on the night before day 1 of the study, age, and gender. This study was limited by a small sample size and should be expanded to further investigate the effect of various restudy techniques, such as using flashcards or handouts while learning anatomy.

Development of a mobile application to improve exercise accuracy and quality of life in knee osteoarthritis patients: a randomized controlled trial.

IntroductionKnee Osteoarthritis (OA) is a degenerative joint disease that needs consistent exercise and an accurate understanding of the condition for long-term maintenance. While the accessibility of outpatient care is essential for disease management, many patients lack the resources to receive adequate healthcare. To address this challenge, we developed a not-for-profit interactive mobile application that provides a disease-specific educational background and a structured exercise regimen to patients.Material and methods“Rak Kao” (English translation: Love-Your-Knee) mobile application was designed to analyze the questionnaire data to assess the stage of knee OA and generate a personalized recommendation of treatment and exercise type using rule-based and Artificial Intelligence (AI) techniques. A single-blinded study was conducted with patients (n = 82) who were randomly assigned to the mobile application group (M-group) and the handout group (H-group). Patient groups were controlled for age, gender, BMI, onset of pain, grade of disease, education level, and occupation. Accuracy in performance of three prescribed knee exercises (catch-bend-down, stretch-touch-feet, and sit-stretch-hold) was evaluated. Clinical outcomes were evaluated before and after the 4-weeks program to assess the range of motion, symptoms, pain, physical activity, and quality of life via the KOOS and KSS scores.ResultsCompletion of the study led to significantly more overall exercise accuracy in the M-group (76.2%) than the H-group (52.5%). Activities of daily life, quality of life, ability to do sports and recreational activities were significantly more improved in the M-group than the H-group (p < .01). No difference in the range of motion between groups. Satisfaction of patients’ experience was higher in the M-group than the H-group (p = .001) after the 4-week regimen.ConclusionsWith the better accuracy and outcomes for rehabilitation in the M-group than the H-group, we strongly recommend using our mobile application as a better alternative than handouts for exercises and information for patients with knee OA.Trial registrationClinicalTrials.gov: NCT03666585

Exercise handout and one-on-one hand therapy for management of stiffness after plaster cast immobilization of simple phalangeal and metacarpal fractures in children: A randomized, noninferiority trial

Study DesignThis is a noninferior, single-blind, randomized controlled trial. IntroductionJoint stiffness is common after plaster cast immobilization for simple phalanx and metacarpal fractures in children. The limited literature suggests this joint stiffness in children resolves without one-on-one therapy; however, without robust studies confirming that there is no detrimental effect from withdrawing treatment, many children are still referred. Purpose of the StudyThe purpose of this study was to determine if an educational handout for self-management of stiffness is noninferior to one-on-one hand therapy for achieving full range of motion (ROM). MethodsParticipants were randomly assigned to group one who received the handout or group two who received hand therapy in addition to the handout. The ROM was measured by composite flexion and total active motion (TAM). The noninferiority margin was 10% difference between the two groups in the proportion of participants who achieved full ROM at two weeks after cast removal. ResultsSixty participants in each group completed the study. Group difference for composite flexion was 1.7% (95% CI: −3.9% to 7.2%), demonstrating noninferiority. Group difference for TAM was inconclusive at 8.3% (95% CI: −2.1% to 18.7%). Sensitivity analysis adjusting for participants with full composite flexion at the baseline resulted in the group difference for composite flexion of 3.1% (95% CI: −3.6% to 9.8%), maintaining noninferiority, but group difference for TAM at 10.4% (95% CI: 0.0% to 20.9%), was inconclusive with the handout group significantly worse. ConclusionAn educational handout is noninferior to hand therapy for achieving full ROM in composite flexion but not TAM. This needs to be taken into consideration for changing clinical practise.

Effect of Instructional Format on Veterinary Students' Task Performance and Emotional State during a Simulation-Based Canine Endotracheal Intubation Laboratory: Handout versus Video.

Video- versus handout-based instructions may influence student outcomes during simulation training and competency-based assessments. Forty-five third-year veterinary students voluntarily participated in a simulation module on canine endotracheal intubation. A prospective, randomized, double-blinded study investigated the impact of video (n = 23) versus handout (n = 22) instructions on student confidence, anxiety, and task performance. Students self-scored their confidence and anxiety before and after the simulation. During the simulation laboratory, three raters independently evaluated student performance using a 20-item formal assessment tool with a 5-point global rating scale. No significant between- or within-group differences (p > .05) were found for both confidence and anxiety scores. Video-based instructions were associated with significantly higher (p < .05) total formal assessment scores compared with handout-based instructions. The video group had significantly higher scores than the handout group on 3 of the 20 individual skills (items) assessed: placement of tie to the adaptor-endotracheal tube complex (p < .05), using the anesthetic machine (p < .01), and pop-off valve management (p < .001). Inter-rater reliability as assessed by Cronbach's α (.92), and Kendall's W (.89) was excellent and almost perfect, respectively. A two-faceted crossed-design generalizability analysis yielded G coefficients for both the handout (Ep2 = .68) and the video (Ep2 = .72) groups. Video instructions may be associated with higher performance scores than handout instructions during endotracheal intubation simulation training. Further research into skill retention and learning styles is warranted.

A comparison of teaching three common ear, nose, and throat conditions to medical students through video podcasts and written handouts: a pilot study

BackgroundThis pilot study conducted at the Peninsula Medical School is one of very few studies to compare the use of video podcasts to traditional learning resources for medical students.MethodsWe developed written handouts and video podcasts for three common ear, nose, and throat conditions; epistaxis, otitis media, and tonsillitis. Forty-one second-year students were recruited via email. Students completed a 60-item true or false statement test written by the senior author (20 questions per subject). Students were subsequently randomized to podcast or handouts. Students were able to access their resource via their unique university login on the university homepage and were given 3 weeks to use their resource. They then completed the same 60-item test.ResultsBoth podcasts and handouts demonstrated a statistically significant increase in student scores (podcasts mean increase in scores 4.7, P=0.004, 95% confidence interval =0.07). Handout mean increase in scores 5.3, P=0.015, 95% confidence interval =0.11). However, there was no significant difference (P=0.07) between the two, with the handout group scoring fractionally higher (podcasts average post-exposure score =37.3 vs handout 37.8) with a larger average improvement. A 5-point Likert scale questionnaire demonstrated that medical students enjoy using reusable learning objects such as podcasts and feel that they should be used more in their curriculum.ConclusionPodcasts are as good as traditional handouts in teaching second-year medical students three core ear, nose, and throat conditions and enhance their learning experience.

Comparison of Effectiveness of Paper Handout vs. Video Media in Reducing Level of Anxiety in Patients Scheduled for Upper GI Endoscopy

Background: Anxiety is common in patients undergoing endoscopy. Pre-endoscopy education may decrease the level of anxiety. Limited data on the use of educational video media in decreasing anxiety among upper endoscopy (EGD) patients are available. Aims: To compare the efficacy of a paper handout with that of video media in reducing patient anxiety in EGD Methods: A prospective randomized study from February 2010 to February 2012 was conducted. The patients were randomized into either the paper handout group (Group A) or the paper handout with video media one (Group B), and completed a validated Thai version of the State-Trait Anxiety Inventory (STAI) questionnaire assessing their state anxiety (SA) and trait anxiety at baseline and after education. Results. Ninety-one patients were recruited – 50 were in group A and 41 in group B. In Group A, SA was high in 3 participants and moderate in the other 47 at baseline, and high among 28 and moderate in the remaining 22 post education (p = 0.00). In Group B, high-level SA was observed in 4 patients and medium-level in the other 37 at baseline, and high in 13 and medium in 28 post education(p = 0.012). The baseline SAs between the two groups were not statistically different (p = 0.69). The post-education SA was lower in Group B than Group A (p = 0.02). The mean SA score + SD at baseline was 21.04 + 5.89 in Group A and 20.49 + 5.31 in Group B (p = 0.64). The mean SA score + SD after education in Group A was 22.38 + 5.82 and in Group B was 19.71 + 5.03 (p = 0.021). Conclusion: Education increased SA, and the video media reduced SA more than the paper handout.

An educational intervention on drug interactions and contraceptive options for epilepsy patients: a pilot randomized controlled trial

ObjectiveThis pilot study investigates whether an educational handout could increase short-term information retention about drug interactions between antiepileptic drugs (AEDs) and hormonal contraceptives among female epilepsy patients of reproductive age. Study designThis is a pilot randomized controlled trial of an educational intervention among reproductive-age women with epilepsy in an academic neurology clinic. Investigators measured knowledge before and after participants received either usual care or the educational handout. The 10-question test assessed increased knowledge of which AEDs affected efficacy of certain hormonal contraceptives and was assessed by calculating the improvement in score between the pretest and posttest. The educational handout included the names of AEDs that have drug interactions with certain contraceptives and the efficacy of the contraceptives. ResultsA total of 42 epilepsy patients participated in this study. Fourteen participants were taking AEDs that are enzyme p450 inducers and 13 participants were taking Lamotrigine. Twenty women were randomized to receive the educational handout and 22 women were randomized to usual care. We found no statistical difference in the groups with regard to age, ethnicity or level of education. We found a significantly higher improvement in quiz scores in the educational handout group (3.65 point increase) compared to the usual care group (0.68 point increase) as calculated by the Student's two-sample t test (p<.001). ConclusionsAn educational handout on drug interactions and contraceptives resulted in increased short-term information retention on this topic among reproductive-age female epilepsy patients. ImplicationsThis pilot study highlights the need for further larger studies to evaluate the impact of educational interventions on improving patient knowledge about the drug interaction of AEDs and hormonal contraceptives.

MP75-10 PATIENT EDUCATION AND THE IMPACT ON URETEROSCOPY EXPERIENCE

You have accessJournal of UrologyStone Disease: Evaluation I1 Apr 2015MP75-10 PATIENT EDUCATION AND THE IMPACT ON URETEROSCOPY EXPERIENCE Nathan Grunewald, Carley Davis, and Jonathan Amos Nathan GrunewaldNathan Grunewald More articles by this author , Carley DavisCarley Davis More articles by this author , and Jonathan AmosJonathan Amos More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2707AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary lithiasis is a common problem where treatment is influenced by patient comorbidities, anatomy, as well as the patient's tolerance for medical expulsive therapy. Endoscopy is a common method to treat upper tract urinary lithiasis. To manage procedural related ureteral edema and prevent urinary obstruction a ureteral stent is often placed post operatively. Ureteral stents are well known to negatively impact patient quality of life and cause significant morbidity. We set out to improve patient understanding of ureteroscopy and the expected post-operative course, including symptom identification, by providing additional patient counseling with an accompanying handout. METHODS A patient handout on ureteroscopy was created focusing on the procedure and expectations. Patients and family were provided advanced patient counseling on ureteroscopy including a thorough review of the handout. We performed a retrospective chart review of all patients from a single surgeon who performed ureteroscopy with laser lithotripsy and ureteral stent placement for renal or ureteral lithiasis. The primary outcome was to identify whether the patient in the 6 weeks after their procedure had a “post-operative qualified morbidity” event. These events included complaints of hematuria, flank pain on urination, general flank pain, post stent removal pain, bladder spasms, nausea and/or vomiting, general stent removal questions, and other. RESULTS 142 patients underwent ureteroscopy with laser lithotripsy treatment and 56 of the 142 patients received advanced counseling with handout. Overall, 46 patients in the pre-handout group had a postoperative qualified morbidity encounter as compared to 18 in the post handout group. This resented a significant difference between the two groups (p=0.01). Qualified encounter complaints in the pre- vs. post-handout group included hematuria (12/6) (first number is the pre-handout group), flank pain with urination (7/3), general flank pain (10/7), post stent removal pain (13/5), bladder spasms (4/4), nausea and/or vomiting (6/5), stent removal questions (8/2), and emergency department visits (12/5). CONCLUSIONS We believe this demonstrates patient education pre-operatively regarding the details of their upcoming procedure and the expected post-operative course significantly decreases patient post-operative concerns and their utilization of resources for normal sequela of ureteroscopy. This can be done without adding significant amount of time to office visits or day of surgery pre-operative conference with patient, family and friends. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e951 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nathan Grunewald More articles by this author Carley Davis More articles by this author Jonathan Amos More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Informed consent when prescribing medication: A randomized controlled trial

To determine patient recall of specific risks associated with medication prescription and whether or not handouts are an effective tool to augment the informed consent process. Double-blinded, randomized, controlled trial. Informed consent for prednisone prescriptions was studied by comparing the effect of a verbal discussion (describing 10 specific adverse drug reactions) in conjunction with a handout going over same, to a verbal discussion alone. Blinded assessments occurred by telephone interview 2 to 4 weeks following the intervention. Outcomes assessed were the number of risks of prednisone that patients could list and the number of risks they recalled having discussed with their physician. Other demographic details were also collected. Twenty-five participants were randomly allocated to each group. Without prompting, the median number of risks spontaneously recalled by the handout group was not significantly different than the control group, and both groups had very low recall (two vs. one, P = .24). When provided a list of potential side effects, it was observed that the handout group recalled a higher median number of risks having been discussed with their physician compared to patients in the control group (eight vs. five, P = .003). The groups' demographics were otherwise identical. Patients in general did not remember discussing adverse prednisone risks with their physician even a short time after the discussion took place. Although the patient handout resulted in improved recall of risks following the prescription of prednisone, its importance in the informed medication consent process remains an open question. 1b.

The Effect of Primary Care Interventions on Children's Media Viewing Habits and Exposure to Violence

ObjectiveTo determine if brief primary care interventions can affect children's media viewing habits and exposure to violence. MethodsEnglish- and Spanish-speaking parents of 2- to 12-year-old children presenting to a pediatric primary care clinic participated in a randomized controlled trial. There were 2 intervention groups; one group viewed 5 minutes from the Play Nicely program and another received a handout, "Pulling the Plug on TV Violence." There were 2 control groups; the primary control group received standard primary care, and the alternative control group viewed a program about obesity prevention. The outcome measure was parental report of changes in media viewing habits and changes in exposure to violence. ResultsA total of 312 of 443 parents who were randomized completed a 2-week follow-up survey. Compared with the primary control group, parents in the video intervention group were more likely to report a change in their children's media viewing habits (odds ratio [OR] 3.29; 95% confidence interval [CI] 1.66–6.51) and a change in their children's exposure to violence (OR 4.26; 95% CI 1.95–9.27). Compared with the primary control group, parents in the handout group were more likely to report a change in their children's media viewing habits (OR 4.35; 95% CI 2.20–8.60) and a change in their children's exposure to violence (OR 3.35; 95% CI 1.52–7.35). ConclusionsBrief primary care interventions can affect children's media viewing habits and children's exposure to violence. These results have implications for how to improve primary care services related to decreasing children's media exposure and violence prevention.

Comparative effectiveness of videotape and handout mode of instructions for teaching exercises: skill retention in normal children

BackgroundTeaching of motor skills is fundamental to physical therapy practice. In order to optimize the benefits of these teaching and training efforts, various forms of patient education material are developed and handed out to patients. One very important fact has been overlooked. While comparative effectiveness of various modes of instruction has been studied in adults, attention has not been paid to the fact that learning capabilities of children are different from that of adults. The intent of the present study is to compare the effectiveness of video and handout mode of instructions specifically on children.MethodsA total of 115 normal elementary-age children aged 10 to 12 years of age were studied. The children were randomized into two groups: A) the video group, and B) the handout group. The video group viewed the video for physical therapy exercises while the handout group was provided with paper handouts especially designed according to the readability of their age group.ResultsStatistical analysis using the student's't' test showed that subjects of both the video and handout groups exhibited equal overall performance accuracy. There was no significant difference between the groups both in acquisition and retention accuracy tests.ConclusionThe findings of the present study suggest that if the readability and instructional principles applicable to different target age groups are strictly adhered to, then both video as well as handout modes of instructions result in similar feedback and memory recall in ten to twelve year-old children. Principles of readability related to the patient age are of utmost importance when designing the patient education material. These findings suggest that the less expensive handouts can be an effective instructional aid for teaching exercises to children with various neuromuscular, rheumatic, and orthopedics conditions and the most costly videotape techniques are not necessarily better.

Multimedia Approach to Preoperative Adenotonsillectomy Counseling

The primary objective was to compare retention of knowledge of surgical risks in parents of children having an adenotonsillectomy who received a preoperative handout or watched a video, in addition to standard counseling. A secondary objective was to determine whether time from counseling to day of surgery affects risk retention. Prospective randomized control study. Tertiary referral center. The study, conducted March 2010 through April 2011, included participants who had children undergoing adenotonsillectomy. The preoperative and postoperative test scores of those undergoing verbal counseling, counseling with handout, or counseling with video were compared. Forty-five participants were tasked to identify 9 risks of adenotonsillectomy. Preoperatively, participants identified an average of 6.8 (95% confidence interval [CI], 6.2-7.3) in the counseling group, 7.3 (95% CI, 6.4-8.3) in the counseling and handout group, and 6.6 (95% CI, 5.9-7.3) in the counseling and video group (P = .32). Postoperatively, participants identified an average of 5.8 (95% CI, 4.9-6.7) in the counseling group, 6.5 (95% CI, 5.3-7.6) in the counseling and handout group, and 5.2 (95% CI, 4.1-6.3) in the counseling and video group (P = .19). Time between preoperative counseling and day of surgery was inversely correlated with postoperative score (β -.34, P = .02). Participants were not able to identify all of the risks associated with adenotonsillectomy. There was no difference in identification of risks associated with adenotonsillectomy among different modalities of counseling. Participants retained more information when there was less time between the preoperative counseling and day of surgery.

Multimedia Approach to Adentonsillectomy Preoperative Counseling

Objective: 1) Compare surgical risk retention in participants who received a handout or watched a video in addition to standard verbal preoperative counseling. 2) Determine if time from counseling to day of surgery affects risk retention. Method: We performed a prospective randomized control study in March 2010 through February 2011 in participants who had children undergoing adenotonsillectomy. Those unable to perform pre- and postoperative testing were excluded. We compared the preoperative and postoperative test scores of those undergoing verbal counseling, counseling with handout, or counseling with video. Results: A total of 27 participants were tasked to identify 9 risks of adenotonsillectomy. Preoperatively, participants identified an average of 6.5 (SD 1.08) in the counseling group, 7.1 (SD 1.9) in the counseling and handout group, and 6.77 (SD 1.5) in the counseling and video group; P = .54. Postoperatively, participants identified an average of 5.3 (SD 1.4) in the counseling group, 6.5 (SD 2) in the counseling and handout group, and 5.3 (SD 2.1) in the counseling and video group; P = .29. Time between preoperative counseling and day of surgery were inversely correlated with postoperative score, correlation coefficient -0.36; P = .07. Conclusion: Participants were not able to identify all of the risks associated with adenotonsillectomy. There was no difference in identification of risks associated with adenotonsillectomy among different modalities of counseling. Participants retained more information when there were fewer days between preoperative counseling and day of surgery.

Educating Adolescents About Acne Vulgaris

To compare the efficacy of written handouts with that of audiovisual computerized presentations in educating adolescents about acne vulgaris. Randomized study. A private dermatology office or 1 of 3 general pediatric clinics in New Haven. One hundred one adolescent patients, aged 13 to 17 years. Intervention All participants completed a brief enrollment questionnaire to gauge baseline knowledge of acne vulgaris. Subjects were then randomized to either receive a written handout or watch an audiovisual computerized presentation. Immediately following the intervention, and again at 1 month, patients were asked to complete identical questionnaires to assess change in knowledge. Change in knowledge about acne vulgaris, as indicated by performance on preintervention, postintervention, and 1-month follow-up questionnaires. Baseline questionnaires were completed by 21 patients in the pilot study and 80 patients in the revised study; 17 (81%) and 77 (96%) completed the respective studies. In both the pilot (P = .64) and revised (P = .63) studies, there was no significant difference between intervention groups in terms of baseline knowledge or gain in knowledge. Immediately postintervention, both groups showed significant improvement from baseline (P < .001 in the revised study and P < .01 in the pilot study). At the 1-month follow-up, patients in the pilot study randomized to receive the computerized presentation still showed significant gain in knowledge from baseline (P < .05), while those in the handout group did not. Meanwhile, both intervention groups in the revised study continued to show significant gain in knowledge from baseline at 1 month (P < .001). Conclusion Both written handouts and audiovisual computerized presentations about acne vulgaris confer significant and equivalent benefits in terms of short- and long-term knowledge gains among adolescent patients with acne.

Effects of Live, Videotaped, or Written Instruction on Learning an Upper-Extremity Exercise Program

Today's health care environment encourages cost containment in many aspects of patient care, including exercise instruction in physical therapy. The purpose of this study was to determine whether different modes of instruction affect the learning of an exercise program, as measured by retention test performance immediately after the instruction and practice and after a 1-day delay. Subjects were 40 people, aged 26 to 51 years (mean=38.4, SD=7.4), with no known shoulder pathology. Subjects were instructed in a series of 5 shoulder exercises by 1 of 4 modes of instruction: (1) live modeling, (2) corrected-error videotape, (3) error-free videotape, and (4) handout alone. Subjects who received instruction from handout materials alone (handout group) exhibited poorer performance accuracy than subjects who received live or videotaped modeling and exercise instruction. In addition, the total number of errors of the handout group was more than twice the average of the live instruction and videotape instruction groups. No differences were found between the live instruction group and the 2 groups that received videotaped instruction. Live and videotaped modeling are more effective than a handout alone for achieving performance accuracy of a basic exercise program, as measured by immediate and delayed retention tests.

Effects of three types of lecture notes on medical student achievement.

Two parallel studies were conducted with junior medical students to determine what influence the forms of lecture notes would have on learning. The three types of notes given to the students were: a comprehensive manuscript of the lecture containing text, tables, and figures; a partial handout which included some illustrations but required substantial annotation by the students; and a skeleton outline containing no data from the lecture. The students' knowledge about the subject was measured before the lecture, immediately after the lecture, two to four weeks later, and approximately three months later. The students' responses to questionnaires indicated a strong preference for very detained handouts as essential to preparation for examinations. By contract, the students' performances on tests generally were better for those who had received the partial or skeleton handout formats. This was particularly true for information presented during the last quarter of each lecture, when learning efficiency of the skeleton handout group increased while the other two handout groups exhibited learning fatigue. It was concluded that learning by medical students was improved when they recorded notes in class.