Comparison of Online to Face-To-Face Instruction for Anatomy Review in a ThirdYear Clinical Course

ABSTRACT

Objective Online/computer-assisted learning has been used extensively in medical education in standalone and hybrid formats. Because of time restraints, the online format may be ideal for providing foundational review material in clinical courses, but the effectiveness of the online format for review purposes in this setting has not been adequately investigated. This project compared student learning and satisfaction delivered by two different methods in a special populations course for third-year doctor of chiropractic students. The two methods of delivery were 1) a face-to-face lecture (F2FL) on pediatric spinal anatomy, and 2) an online learning module (OLM) covering the same material. Methods This study was approved by the institutional IRB. A cohort comparison, mixed methods study design compared student learning and satisfaction of a pediatric spinal anatomy review delivered through a F2FL (n=22) and OLM (n=18) in two successive 2019 (pre-COVID) course offerings. Previously validated pre- and post-tests for the material were given to the students one week prior and one week following the intervention (either F2FL or week-long availability of the OLM). An instructor not affiliated with the course completed a “Similarity of Material Assessment” that evaluated the similarity of content in each method of delivery. Identical tests were given to each group. In addition, a survey assessing the method of delivery, comfort with technology, and preference of F2FL vs. OLM of review material, was completed by both groups immediately following administration of the post-test. Differences between pre-and post-test results were assessed using repeated measures ANOVA with F2FL and OLM as groups and pre-and post-test results as repeated measures. Results The content presented to the F2FL and OLM groups was judged to be the same by the independent instructor. Testing results showed an improvement with both groups from preto post-test [F2FL 54.6%, p<0.0001 vs. OLM 48.9%, p<0.0001 (OLM 52.35%, p<0.0001 with one dramatic outlier removed)], with no significant difference between test results between the F2FL and OLM groups [p=0.53 (p=0.82 with outlier removed)]. The survey showed 83.3% of OLM students felt the online method was effective and 88.9% would prefer the material to be presented online;80% of the F2F group thought the lecture was engaging/effective and 60% would have preferred to have the material presented online. Conclusions The OLM was found to be as effective as the F2FL for the content assessed, and students were highly satisfied with the online method of instruction of the anatomy review material. This strategy could potentially be applied to provide additional review materials fundamental to other clinical courses. The OLM method allows for the material to be developed and given by content experts while also freeing valuable in-class time to be used for more experiential learning in clinical courses.